Theories in Health Education

Banduras Self Efficacy Theory

Penders Health Promotion
Theory
Health Belief Model
Greens Precede-Proceed Model

Bandura's Theory Of SelfEfficacy

Self-efficacy refers to the belief that
one can execute given levels of
performance (a more specific notion).

Self-efficacy is the extent or strength of

one's belief in one's own ability to complete
tasks and reach goals.Ps ychologists have
studied self-efficacy from several
perspectives, noting various paths in the
development of self-efficacy; the dynamics
of self-efficacy, and lack thereof, in many
different settings; interactions between selfefficacy and self-concept; and habits of
attribution that contribute to, or detract
from, self-efficacy.

Bandura's Theory Of
Self-Efficacy

This can be seen as the ability to persist and a person's ability to succeed with
a task. As an example, self-efficacy directly relates to how long someone will
stick to a workout regimen or a diet. High and low self-efficacy determine
whether or not someone will choose to take on a challenging task or "write it
off" as impossible.
Self-efficacy affects every area of human endeavor. By determining the
beliefs a person holds regarding his or her power to affect situations, it
strongly influences both the power a person actually has to face challenges
competently and the choices a person is most likely to make. These effects are
particularly apparent, and compelling, with regard to behaviors affecting
health.
Judge et al. (2002) argued the concepts of locus of control,
neuroticism, generalized self-efficacy (which differs from
Bandura's theory of self-efficacy) and self-esteem measured
the same, single factor and demonstrated them to be related

Bandura's Theory Of SelfEfficacy

Bandura's Theory Of SelfEfficacy

Vicarious Experience:
Bandura argues that most of our learned
behaviors are modeled. If an individual
sees others doing something they may
persuade themselves that they can do it
to.
What factors affect modeling and the
development of self-efficacy?
Skill level, similarity, many models,
process of overcoming difficulty?
Imagery is a form of vicarious experience.

Bandura's Theory Of
Self-Efficacy
Verbal Persuasion
People can be led into believing that they can
cope successfully with what has overwhelmed
them in the past (by others or themselves).
Weaker than successful performance since
individuals do not have an authentic
experiential base to believe in their own selfefficacy.
Here, it is important not only to persuade one
of their efficacy, but to provide the conditions
which will facilitate effective performance.
Development of self-talk strategies.

Bandura's Theory Of SelfEfficacy

Bandura: self-efficacy predicts
actual performance provided
that necessary skills and
appropriate incentives are
present.
Self-efficacy is also believed to
be situation and time specific.
Bandura distinguishes between:
Knowing that a particular response will
result in a particular outcome, and (b)
Believing that one has the capability of
executing such a response

Bandura's Theory Of
Self-Efficacy
Emotional/Physiological Arousal:
Physiological States - we judge our own self-efficacy by how
we perceive our anxiety level in different situations.
Anxiety, arousal, and avoidant behavior are largely coeffects
of perceived coping inefficacy. People avoid potentially
threatening situations and activities, not because they
experience anxiety arousal or anticipate they will be
anxious, but because they believe they will be unable to
cope successfully with situations they regard as risky.
Suggests: need to develop effective coping strategies stress reduction techniques (cognitive and physical), use of
various kinds of imagery, biofeedback, massage) - to
develop belief that one has arsenal of coping strategies.

Bandura's Theory Of SelfEfficacy

Outcomes are independent of
perceived self-efficacy when
reinforcement is
discriminatively awarded
Perceived self-efficacy
influences choice of behavioral
settings
Bandura's Theory Of SelfEfficacy
Goal Setting and Self-efficacy

Nola Penders Health Promotion

Theory

Nola Penders Health Promotion

Theory
The health promotion model notes that each person has
unique personal characteristics and experiences that affect
subsequent actions. The set of variables for behavioral
specific knowledge and affect have important motivational
significance.
These variables can be modified through nursing actions.
Health promoting behavior is the desired behavioral
outcome and is the end point in the HPM.
Health promoting behaviors should result in improved
health, enhanced functional ability and better quality of life
at all stages of development.
The final behavioral demand is also influenced by the
immediate competing demand and preferences, which can
derail an intended health promoting actions.

Nola Penders Health Promotion

Theory
Major Concepts

Health promotion is defined as behavior motivated by the desire to increase well-being and actualize
human health potential. It is an approach to wellness.
On the other hand, health protection or illness prevention is described as behavior motivated desire
to actively avoid illness, detect it early, or maintain functioning within the constraints of illness.
Individual characteristics and experiences (prior related behavior and personal factors).
Behavior-specific cognitions and affect (perceived benefits of action, perceived barriers to action,
perceived self-efficacy, activity-related affect, interpersonal influences, and situational influences).
Behavioral outcomes (commitment to a plan of action, immediate competing demands and
preferences, and health-promoting behavior).

Nola Penders Health Promotion

Theory
Subconcepts
Personal Factors
Personal factors categorized as biological, psychological and socio-cultural. These
factors are predictive of a given behavior and shaped by the nature of the target
behavior being considered.
a. Personal biological factors
Include variable such as age gender body mass index pubertal status, aerobic capacity,
strength, agility, or balance.
b. Personal psychological factors
Include variables such as self esteem self motivation personal competence perceived
health status and definition of health.
c. Personal socio-cultural factors
Include variables such as race ethnicity, acculturation, education and socioeconomic
status.
Perceived Benefits of Action
Anticipated positive outcomes that will occur from health behavior.

Nola Penders Health Promotion

Theory
Subconcepts
Perceived Self Efficacy
Judgment of personal capability to organize and execute a health-promoting behavior.
Perceived self efficacy influences perceived barriers to action so higher efficacy result in
lowered perceptions of barriers to the performance of the behavior.
Activity Related Affect
Subjective positive or negative feeling that occur before, during and following behavior
based on the stimulus properties of the behavior itself.
Activity-related affect influences perceived self-efficacy, which means the more positive
the subjective feeling, the greater the feeling of efficacy. In turn, increased feelings of
efficacy can generate further positive affect.
Interpersonal Influences
Cognition concerning behaviors, beliefs, or attitudes of the others.
Interpersonal influences include: norms (expectations of significant others), social support
(instrumental and emotional encouragement) and modeling (vicarious learning through
observing others engaged in a particular behavior).
Primary sources of interpersonal influences are families, peers, and healthcare providers.

Nola Penders Health Promotion

Theory
Subconcepts
Situational Influences
Personal perceptions and cognitions of any given situation or context that can
facilitate or impede behavior. Include perceptions of options available, demand
characteristics and aesthetic features of the environment in which given health
promoting is proposed to take place. Situational influences may have direct or
indirect influences on health behavior.
Commitment to Plan Of Action
The concept of intention and identification of a planned strategy leads to
implementation of health behavior
Immediate Competing Demands and Preferences
Competing demands are those alternative behaviors over which individuals have
low control because there are environmental contingencies such as work or family
care responsibilities.
Competing preferences are alternative behaviors over which individuals exert
relatively high control, such as choice of ice cream or apple for a snack

Health Belief Model (HBM)

Health Belief Model (HBM)

The Health Belief Model (HBM) is one of the first
theories of health behavior.
It was developed in the 1950s by a group of U.S.
Public Health Service social psychologists who
wanted to explain why so few people were
participating in programs to prevent and detect
disease.
HBM is a good model for addressing problem
behaviors that evoke health concerns (e.g.,
high-risk sexual behavior and the possibility of
contracting HIV) (Croyle RT, 2005)

Health Belief Model (HBM)

The health belief model proposes that a person's
health-related behavior depends on the person's
perception of four critical areas:

the
the
the
the

severity of a potential illness,

person's susceptibility to that illness,
benefits of taking a preventive action, and
barriers to taking that action.

HBM is a popular model applied in nursing,

especially in issues focusing on patient
compliance and preventive health care practices.

Health Belief Model (HBM)

The model postulates that health-seeking
behaviour is influenced by a persons perception
of a threat posed by a health problem and the
value associated with actions aimed at reducing
the threat.
HBM addresses the relationship between a
persons beliefs and behaviors. It provides a way
to understanding and predicting how clients will
behave in relation to their health and how they
will comply with health care therapies.

Health Belief Model (HBM)

THE MAJOR CONCEPTS AND DEFINITIONS OF
THE HEALTH PROMOTION MODEL
There are six major concepts in HBM:
1. Perceived Susceptibility
2. Perceived severity
3. Perceived benefits
4. Perceived costs
5. Motivation
6. Enabling or modifying factors

Health Belief Model (HBM)

Perceived Susceptibility: refers to a persons
perception that a health problem is personally
relevant or that a diagnosis of illness is accurate.
Perceived severity: even when one recognizes
personal susceptibility, action will not occur unless the
individual perceives the severity to be high enough to
have serious organic or social complications.
Perceived benefits: refers to the patients belief
that a given treatment will cure the illness or help to
prevent it.
Perceived Costs: refers to the complexity, duration,
and accessibility and accessibility of the treatment.

Health Belief Model (HBM)

Motivation: includes the desire to
comply with a treatment and the belief
that people should do what.
Modifying factors: include personality
variables, patient satisfaction, and sociodemographic factors.

Greens Precede-Proceed
Model

Greens Precede-Proceed
Model
The Precede-Proceed model is a cost-benefit
evaluation framework proposed in 1974 by Dr.
Lawrence W. Green, that can help health program
planners, policy makers, and other evaluators
analyze situations and design health programs
efficiently.
It provides a comprehensive structure for assessing
health and quality of life needs, and for designing,
implementing, and evaluating health promotion and
other public health programs to meet those needs. [

Greens Precede-Proceed
Model
One purpose and guiding principle of the PrecedeProceed model is to direct initial attention to
outcomes, rather than inputs. It guides planners
through a process that starts with desired outcomes
and then works backwards in the causal chain to
identify a mix of strategies for achieving those
objectives.
A fundamental assumption of the model is the
active participation of its intended audience that is,
that the participants ("consumers") will take an
active part in defining their own problems,
establishing their goals, and developing their
solutions.

Greens Precede-Proceed
Model
In this framework, health behavior is
regarded as being influenced by both
individual and environmental factors, and
hence has two distinct parts.
First is an educational diagnosis PRECEDE, an acronym for Predisposing,
Reinforcing and Enabling Constructs in
Educational Diagnosis and Evaluation.
Second is an ecological diagnosis
PROCEED, for Policy, Regulatory, and
Organizational Constructs in Educational
and Environmental Development.

Greens Precede-Proceed
Model
The model is multidimensional and is
founded in the social/behavioral
sciences, epidemiology, administration,
and education. The systematic
utilization of the framework in a series
of clinical and field trials confirmed the
utility and predictive validity of the
model as a planning tool (e.g. Green,
Levine, & Deeds).

Greens Precede-Proceed
Model
The PRECEDE-PROCEED model is a participatory
model for creating successful community health
promotion and other public health interventions.
It is based on the premise that behavior change is
by and large voluntary, and that health programs
are more likely to be effective if they are planned
and evaluated with the active participation of
those people who will have to implement them,
and those who are affected by them.
that use the Precede-Proceed model as a
guideline.

Greens Precede-Proceed
Model
Thus health and other issues must be
looked at in the context of the
community. Interventions designed for
behavior change to help prevent injuries
and violence, improve heart-healthy
behaviuors, and those to improve and
increase scholarly productivity among
health education faculty[8] are among the
more than 1000 published applications
that have been developed or evaluated

Next Week Discussion

2nd week
B. Perspective on Teaching and Learning
1. Overview of Education on Health Care
2. Concepts of teaching, learning, education
process vis a vis nursing process, historical
foundations for the teaching role of the nurse
3. Role of the Nurse as a Health Educator
ACTIVITY
: ROLE
4. Hallmarks of Effective Teaching
in Nursing
PLAY
5. Principles of Good Teaching Practice
in
(VIDEO)
Undergraduate
Education
6. Barrier to Education and Obstacles to
Learning