P4 Promotion: A Case Study

Using the health belief model, how can nurses encourage patients to make immediate and permanent behavior changes; particularly as they relate to lifestyle choices?

For individuals to be healthy requires the combination of varying levels of physical, mental and social well-being throughout a person's lifetime. Most people find that maintaining their health requires a certain amount of effort and intention. Health programs can help with this effort, but their effectiveness depends on how well health professionals make sure that an individual's attention and information convert to actions and behaviors that succeed (Issel, 2009).

Health belief model was one of the first and most widely recognized theories of health behavior. (Butts & Rich, 2011). This theory was formulated in an attempt to predict health behaviors by focusing on the attitude and beliefs of individuals. It is aimed to determine the likelihood of an individual to participate in health-promotion and disease prevention programs. (Kozier & Erb, 2011). This theory postulated that if a patient is well- motivated, there is a possibility that he will participate in these activities. Motivation can be derived by the individual's perceptions towards his condition. According to Becker (1974), individual perceptions include patient's perceived susceptibility, perceived seriousness of the disease and perceived threat.

Health care providers can overcome differing points of view regarding health promotion and disease prevention by creating a learning environment built on mutual trust, respect and acceptance. The goal is to provide education that is built upon the individual or group strengths that empower and engage the group/individual to be an active participant. It should encourage decision-making that positively affects lifestyle and health behavior changes.

patient that has CHD, (Coronary Heart Disease) and explore the psychological approach to altering the patients perceptions of health promotion, and interventions that are used to facilitate a better quality of health. The author will also examine public health legislation on current health and social care provisions, and evaluate the role of models of health within diverse promotions in practice.

The intrapersonal model focuses on health promotion and health education efforts in order to increase awareness of health-related issues among individuals, such as knowledge, attitudes, personal beliefs, and the individual’s skill set (Riegelman and Kirkwood, 2015). This is important because it zeros in on the individual and what they know and can do in order to allow for change. One of the many models within the intrapersonal theory is the transtheoretical model, also known as the stages of change model. The transtheoretical model’s constructs are that the individual goes through incremental stages when changing a behavior instead of making big changes all at the same time (Riegelman and Kirkwood, 2015). The first construct is the precontemplation stage, where the individual has not yet thought about changing their behavior. Next, is the contemplation stage, where the individual is actively thinking about the pros and cons of change. Then the next stage is preparation, where the individual is thinking about a plan of action. Next, is the action stage, where the change is taking place in the individual’s behavior. Finally, the maintenance stage, where the change becomes a permanent change in the individual’s lifestyle. (Riegelman and Kirkwood, 2015). The importance in this model is the ability

20). Within a 4-H program, health needs are addressed and taught to students. Some of the habits and ideas that are addressed include: healthy eating, physical activity, injury prevention, social-emotional health, and the prevention of alcohol, tobacco, and other drug use (Downey, et al., 2014, p. 14). By teaching these topics to the youth, they are better able to apply them to their lives and the decisions they will make concerning their health and well-being.

Carter, Barba, and Kautz (2013) report culturally tailored education can lead to significant improvements in self-care in African Americans with type 2 diabetes. Also, appropriate dieting, exercise, medical checkups and medication regimens for prevention and management show efficient improvements. The Health Belief Model is realistic and acknowledges that having a desire to change health behavior may not be enough. Therefore, two elements that may be helpful include cues to action and self-efficacy. The cues to action are external whereas, self-efficacy focuses on his or her ability to make a health-related change (Boskey, 2014).

Patient prevention and education should start in the primary care setting where information could be shared with the patient and their love ones. Patient education can be initiated by the primary care provider and the ancillary staff. Initiating this fundamental exchange of information can establish a knowledge base for health promotion behaviors and increase self-management skills that can improve the patient quality of life (Cha et al., 2012).

19. At the intrapersonal level, theories of health behavior assume individuals exist within and are influenced by a

The study discusses the social cognitive theory and relates to it by sending monthly information to the churches that highlights a health behavior change strategy consistent with this theory (Kyryliuk, Baruth, & Wilcox, 2015). The social cognitive theory is defined as “a three-way, dynamic, reciprocal model in which personal factors, environmental influences, and behavior continually interact” (Glanz, Burke, & Rimer, 2015, p. 244). Another way the study incorporates this theory is by evaluating the participants personal factors, such as self-efficacy, environmental factors, such as perceived stress, and behavior, including nutrition and physical activity. It discusses a person’s confidence in their ability to make changes despite encountering obstacles or challenges, which is a variable that is assessed and examined throughout the study (Glanz, Burke, & Rimer, 2015).

The Health Belief Model is commonly used for health promotion and health education. Its’ underlying concept is that health behavior is explained by perception of the disease and the strategies available to lower its occurrence. There are four perceptions of the HBM, which are perceived seriousness, perceived benefit, perceived susceptibility and perceived barriers. In addition to that, more constructs are added to health belief model that includes motivating factor, cues to action and self-efficacy. Each of these constructs in combination or individually, could be used to determine health behavior. The HBM also provides guidelines for the program development allowing planners to address reasons for non-compliance with recommended health action. The health belief model is a process used to promote healthy behavior among individuals who may be at risk of developing adverse health outcomes. A person must gauge their perceptions of severity and susceptibility of developing a disease. Then it is essential to feel vulnerable by these perceptions. Environmental factors can play a role as well as cues to action such as media, and close friends. In order to determine that taking action will be meaningful, the benefits to change must be weighed, against the barriers to change behavior (Green & Murphy, 2014).

The Commitment to Health (CTH) theory was established as a supplement to the TTM and helps to identify, “how early health-behavior activities become lifelong behavior change” (Kelly, 2008, p.148). Kelly (2008) describes CTH as a middle-range theory in her article. Middle-range theories are “theories that have more limited scope, less abstraction, address specific phenomena or concepts and reflect practice” (Potter and Perry, 2005, p. 63). Kelly (2008) believes that CTH can be used to help create evidence-based health promotion plans for patients in the action stage of behavior change.

The Health Belief Model (HBM) is one of the first theories of health behavior. It was developed in the 1950s by social psychologists in the U.S. Public Health Services to better understand the widespread failure of tuberculosis screening programs. Today it continues to be one of the most widely used theories. Research studies use it to explain and predict health behaviors seen in individuals. There is a broad range of health behaviors and subject populations that it is applied in. The concepts in the model involve perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, and self-efficacy. Focusing on the attitudes and beliefs of individuals being studied create an understanding of their

Self-efficacy, for the purpose of this study, may be defined as a person’s optimistic self-belief. This is the belief that a person can develop the skills to perform new or difficult tasks to cope with changes in health and functioning. When a person perceives self-efficacy, it will facilitate goal-setting, effort, investment, persistence, overcoming obstacles and recovery from disappointments and failures. It can be regarded as a positive outlook or proactive way to handle stress factors. It is the ability to successfully cope with health changes, and implies an internal and stable acceptance of changes and ability to successfully adapt to those changes. Perceived self-efficacy is functional in