cNursing-Compare the Health Belief Model, Pender’s Health Promotion Model, and The Transtheoretical Model

The theoretical models under consideration were initiated as part of an eight-model structure to ensure the effectiveness of proposed improvements to the health care system and more so in cost control measures. The models were targeting non-participants in the health sector to have more proactive roles in addition to determining the influences of health behavior. Health Belief Model (HBM) was developed to observe client behaviors. This was after some health screening and preventive services were offered to people at a nominal fee but the U.S Public Health Services observers noticed that some people did not participate in these services (Naldoo, 2000). Researchers there on decided to come up with a framework that would seek to identify why persons would and would not participate in the desired health activity or behavior.

The HBM model was set with three parameters. The first parameter being looking at the modifying factors, which classified people according to the demographics that is, gender, age, and race they belonged to. Also analyzed are social psychological factors such as the social tiers individuals associate with, and how these affect their lives. The analysis further incorporated structural variables including current stereotypes or stigmas associated with the disease. It also looked at what actions the people would likely overtake. The second parameter was individual perceptions. How the public perceive the risk of contracting a disease or illness, what was their perception if they contracted the disease and left it untreated and also their perception on the threat and the confidence that the action they take effect on the threat. The third parameter was the likelihood of action. The model looked at what the perception on effectiveness of intervention. Possible barriers to health services were also described in this model, whether it was cost to the individual, time, pain or convenience. Though the HBM was generally accepted it appeared to be just an expression of the variables potentially affecting behaviors. HBM was supported as a disease avoidance and protective model but not have a eudemonistic appeal.

The Health Promotion Model (HPM) was also similar with HBM in the ways which it categorizes the factors influencing health behaviors. HPM classifies these factors as Modifying factors, perceptual factors and the variables influencing the likelihood of action (Edelman, 2002). The only difference is that HPM is focused mainly on achievement of higher levels of well being and self actualization whereas HBM is just a health protective model. The Modifying issues influencing HPM included behavioral factors, interpersonal pressures, situational factors, as well as biological and demographic issues (Naldoo, 2000). Behavioral influences determine an individual’s prior interaction with a particular situation or activity. The model says that a person’s prior experience may influence a person’s self efficacy in resuming in the activity. Interpersonal influences relate to social support and expectation of others. The model says that families, work colleagues or peers can either encourage or discourage a person towards a given behavior. Situational factors relates to the surrounding environment. Demographic factors in HPM just like in HBM relate to gender, income, age, ethnicity and also educational background.

Demographic factors in HPM are the factors that bring a great difference from the HBM.HPM mainly concentrates on self actualization. A person’s income determines whether a person will engage in preventive services. Before a client aspires to higher levels of self actualization, basic needs must be met. The way a person perceives a disease determines how he will acquire and maintain a health promoting behavior. The ability to learn through observation gives people the opportunity to set their own rules for their behavior without having to learn through their own experience. People define health in different ways; some define it as absence of disease while others define it as optimal physical function. These differences determine what health measures each will take when faced with similar condition.

Transtheoretical Model (TTM) was designed for smokers. It was meant to describe behavior change mechanism for smokers. It had a dimension of change described by temporal, motivational and the constancy aspects of change. The changing aspects in a person are in various stages. The first one where a person would respond to what they were not considering quitting within the next six months called precontemplation (Kleinke, 1998). Then contemplation, a person seriously considers quitting in the next six months but not the next 30 days. In fact he has not even made an attempt to quit for a period of 24 hrs in the previous year. There is also that which is described as preparation or action, whereby the individual has decided to quit within half a year and has made plans to initiate the process within a month.

The difference between HBM, HBM and TTM is that TTM is more specific, dealing with behavior of smokers. The main line of focus is change but an analysis of the extent of resistance to overcoming the addiction. HBM undertakes to analyze the activity in a greater perspective, considering perspective, impact and implications of prevention as some of the characteristics of the activity. HBM on the other hand will try and find out why this people are still in the habit and what factors that will lead them to not quitting.

In nursing practice, I would use my HBM where a client has a knee injury. In this case preventing it is important. Educating the client that first Aid is necessary before visiting a health center. Analyzing the factors influencing visits to health centers as opposed to ordinary home care. Finding out why he would not visit a health center and would rather stay at home. Knee injuries as well as Influenza are regarded as diseases that have no high priority. This requires a higher kind of treatment and is most sensitive. HPM involves keen details in how to prevent it. I would find out what people it mostly affects, why they are affected, and some of the barriers that prevent them from getting medical attention. I would likely use TTM model on a woman with weight disorder to find out why she had not achieved her goal and the factors leading to either improvement of failure.






Naldoo, J., Wills, J. (2000). Health promotion:  Foundations for practice. 2ndedition.Edinburgh, Baillere Tindall Publ

Kleinke, J.D. (1998) Bleeding the edge: the business of health care in the new century. Gaithersburg (MD): Aspen Publishers.

Edelman, C. L., Mandle, C. L.  (2002). Health promotion throughout thelifespan, 5th

Edition.  St. Louis:  Mosby.





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