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Born August 16, 1941 in Lansing, Michigan
Education
 BS, Michigan State University, East Lansing, MI, 1964
 MA, Michigan State University, East Lansing, MI, 1965
 PhD, Northwestern University, Evanston, IL, 1969
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Teaching
Dr. Pender has been a nurse educator for over
forty years. She has taught baccalaureate,
masters, and PhD students; she also mentored a
number of postdoctoral fellows. Currently, she
serves as a Distinguished Professor at Loyola
University Chicago, School of Nursing
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Interests
 Physical activity
 Adolescent health behaviors
 Health promotion
 Health behavior counseling
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Began studying Health Promoting Behavior
in mid 1970’s
 First published Health Promotion Model 1982
 Later revised in late 1980’s and again 1996
 Considered a middle range theorist
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1974: World Health Organization defines HEALTH as…
“a state of complete physical, mental and social wellbeing and not merely the absence of disease and
infirmity”
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1979: The U.S. surgeon general published Healthy
People which was a landmark document stating that
major health advances would result from:
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Improved nutrition
Increased physical fitness
Personal Life styles
Immunizations
Environmental Modifications
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Pender proposed the Health Promotion
Model (HPM) as a framework for
integrating…
Nursing
Behavioral
Science
Perspectives
Health
Promotion
Model
…focuses on factors that influence Health
Behaviors and is a guide to exploring
biopsychosocial processes that motivate
people to engage in behavior to enhance
health
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2.
3.
Major Concepts:
Individual Characteristics and Experiences
Behavior-Specific Cognitions and Affect
Behavior Outcomes
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The Actualizing Tendency: “need to experience all
facets of self and the world about them” (Pender,
1986).
› Driving force toward ↑ levels of well-being
› Individuals/Families are motivated to engage in health
promoting behaviors when they know their own capacity
for growth and potential
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The Stabilizing Tendency: is responsible for
protective maneuvers, primarily maintaining internal
& external environments within a range compatible
with continuing existence…AKA “steady state”
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1.
2.
3.
4.
The HPM is based on the following assumptions, which
reflect both nursing and behavioral science
perspectives:
Individuals seek to actively regulate their own behavior.
Individuals in all their biopsychosocial complexity
interact with the environment, progressively transforming
the environment and being transformed over time.
Health professionals constitute a part of the
interpersonal environment, which exerts influence on
persons throughout their lifespan.
Self-initiated reconfiguration of person-environment
interactive patterns is essential to behavior change
Society
Individuals
Communities
Framework
of
Health
Promotion
Concepts
Health
Promotion
Families
Health
Protection
Communities
at large
Nursing
centers
Workplace
Schools
Hospitals
Progress toward Health Promotion is
“slowed by vested interests in the
economic gains inherent in ‘illnessoriented’ care and by political concerns
about national debt and the high cost of
health services” (Pender, 1986).
“Ultimate goal is empowerment of client for selfdetermination and self management in order to
enable attainment of high level health and wellbeing” (Pender, 1986).
Based on:
1) Individual and family ultimately responsible for own
health
2) Clients have inherent capacity for change in both
constructive and destructive directions
3) Clients have a right to health information in order to
make informed decisions concerning behavior and
lifestyle choices
The health promotion model (HPM) was
designed to be a “complementary
counterpart to models of health
protection.”
 It defines health as a positive dynamic state
not merely the absence of disease.
 Health promotion is directed at increasing a
client’s level of wellbeing.
 The health promotion model describes the
multi dimensional nature of persons as they
interact within their environment to pursue
health.
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Significance
› Are metaparadigm concepts and
propositions addressed by the theory
explicit?
› Are the philosophical claims on which the
theory is based explicit?
› Is the conceptual model on which the theory
was derived explicit?
› Are the authors of antecedent knowledge
acknowledged and citations given?
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Internal Consistency
› Are the context (philosophy and conceptual
model) and the content (concepts and
propositions) of the theory congruent?
› Do the concepts reflect semantic clarity and
consistency?
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Parsimony
› Is the theory content stated clearly and
concisely?
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Testability
› Is the research methodology identified and
congruent with philosophical claims?
› Will data obtained from research sufficiently
capture the essence of the theory?
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Empirical Adequacy
› Are the findings from studies of descriptions
of personal experiences congruent with the
concepts and theory propositions?
› Are theoretical assertions congruent with
emperical evidence?
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Pragmatic Adequacy
› Are education and special training required before
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application of the theory in nursing practice?
Has the theory been applied in the real world of
nursing practice?
Is it generally feasible to implement practice derived
from the theory?
Does the practitioner have the legal ability to
implement and measure the effectiveness of theorybased nursing actions?
Is the application of theory-based nursing action
designed so that comparisons can be made
between outcomes of use of the theory and
outcomes in the same situation when the theory was
not used?
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Pender, N. J. (1987). Health promotion in
nursing practice (2 ed.). Norwalk,
Connecticut.
http://currentnursing.com/nursing_theory/h
ealth_promotion_model.html
http://www.nursingtheory.com
http://www.umich.edu/faculty-staff/nola-jpender
McEwen, M., & Willis, E. M. (2007).
Theoretical basis for nursing (3 ed.).
Philadelphia, PA: Lippincott Williams &
Wilkins.