Running head: HEALTH PROMOTION PLAN
Health Promotion Plan
Dawn A. Platt
Ferris State University
1
HEALTH PROMOTION PLAN
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Abstract
The objective of this paper is to reveal a health promotion plan that I have formulated for myself
in order to achieve good health. I utilized several health assessment tools, which include the
health belief survey, two body mass index (BMI) calculators, and Rosenberg’s self-esteem scale,
to guide me in formulating an appropriate plan. The health promotion plan that I chose revolves
around weight loss and healthy eating habits. I also discussed my transition through the
Transtheoretical model and explained each stage of this model and how it pertained to my health
promotion plan. I selected a wellness nursing diagnosis for which I indicated short-term and
long-term goals and specific interventions to follow in order to be successful in my health
promotion plan. Finally, I examined how the implementation of my health promotion plan has
impacted my life as a nurse, family caretaker, and individual.
Keywords: weight, weight loss, transtheoretical model, weight watchers, health
HEALTH PROMOTION PLAN
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Health Promotion Plan
Nurses are expected to continually promote good health for their patients and educate
them on how to achieve good health. Nurses have the explicit knowledge and the ability to
obtain the knowledge to promote health and provide the appropriate education for patients to
achieve good health. However, when nurses do not personally follow these practices, it can be
difficult to encourage the patient to take the right steps to achieve good health. Nurses need to
explore their own health and health promotion and be willing to take the appropriate steps to
achieve good health in their own personal life. As a registered nurse, I assessed my personal
health and how I was portraying my health promotion across to my patients to form a personal
health promotion plan and wellness nursing diagnosis so that I can achieve good health.
Personal Assessment
According to Pender, Murdaugh, and Parsons (2011), “a thorough assessment of health
and health behaviors is the foundation for tailoring a health promotion-prevention plan to a given
client” (p. 89). In this case, the client happens to be myself. “Assessment provides the database
for making clinical judgments about the client’s health strengths, health problems, nursing
diagnoses, and desired health or behavioral outcomes as well as the interventions likely to be
effective” (Pender, Murdaugh, & Parsons, 2011, p. 89). Having the appropriate health
assessment tools is necessary to obtaining an accurate nursing diagnosis and health promotionprevention plan. After performing a personal assessment of my individual life and health, I came
to the conclusion that my eating habits and weight were an area of my life that needed to be
changed in order to promote health, prevent illness, and achieve good health.
Health Assessment Tools
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Secondary to my personal assessment, I utilized four health assessment tools to help
determine my nursing diagnosis and to formulate a plan. These health assessment tools included
the health beliefs survey (Appendix A), two different body mass index (BMI) calculators
(Appendices B and C), and Rosenberg’s self-esteem scale (Appendix D). The health beliefs
survey is used to indicate if an individual believes they have internal control over their health and
situations that may affect their health. The two BMI calculators, one retrieved from webmd.com
and the other retrieved from the US Department of Health and Human Services: National Heart
Lung and Blood institute at nhlbisupport.com, were used to assess my weight and determine if I
was categorized as being underweight, normal weight, overweight, or obese. According to the
Cambridge Dictionary of Human Biology and Evolution (2005), the BMI calculation was
“developed by the Belgian astronomer [Lambert Adolphe] Quetelet in 1870” and was also
known as Quetelet’s index. BMI calculations are consistently used in determining an
individual’s weight status. Rosenberg’s self-esteem scale “represents an excellent example of
how to assess self-esteem” (Self-Esteem, 2001). It is the “most commonly used measure of
global self-esteem [and] was developed by Morris Rosenberg in 1979” (Self-Esteem, 2001).
Results
The results of the health beliefs survey indicated that I am an individual who believes that
I have internal control of my health and health behaviors (see appendix A for complete results).
I believe that my deliberate actions and behaviors determine if I will become ill or when I
become ill how well I will return to good health. I do not believe so much that chance or
powerful-others determine my health status. This is absolutely important in determining
whether an individual will change health behaviors or not, because those who do not believe
their own behaviors or actions determine their health status may not be willing to make the
HEALTH PROMOTION PLAN
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necessary changes to achieve good health. Furthermore, those who do believe they have internal
control over their health will most likely be the individuals who take action to achieve good
health.
The two different BMI calculators were used at different times during the implementation
of my personal health promotion plan to determine my weight status. The first calculator places
me in a generic category of weight status, while the second calculator gives more detailed
information regarding weight status and health risk based on waist-to-height ratio. Prior to
implementing my health promotion plan my BMI was calculated at approximately 26.4, which
placed me in the overweight category and at increased risk for diabetes, heart disease, stroke, and
some cancers. Currently, my BMI is calculated at approximately 23.4, which placed me at a
normal weight and removed me out of the category of being at high risk for the previously stated
diseases (see appendices B and C for complete results).
The final health assessment tool, which was Rosenberg’s self-esteem scale, was used to
determine if my weight status affected my self-esteem. I performed this assessment prior to
implementation of my health promotion plan and at the present. While there was a difference of
one point in scoring, this assessment indicated that my self-esteem is within normal range, and
my weight status did not overall affect my self-esteem (see appendix D for complete results).
Transtheoretical Model
The transtheoretical model “is an integrative framework to describe how individuals
progress toward adopting and maintaining behavior change” (Pender, Murdaugh, & Parsons,
2011, p. 51). The steps of this framework, in sequential order, include 1) precontemplation, 2)
contemplation, 3) planning or preparation, 4) action, and 5) maintenance (Pender, Murdaugh, &
Parsons, 2011, p. 51). “The premise of this model is that health-related behavior change
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progresses through five stages, regardless of whether the client is trying to quit a healththreatening behavior or adopt a healthy behavior” (Pender, Murdaugh, & Parsons, 2011, p. 51).
The precontemplation stage is when “an individual is not thinking about quitting or
adopting a particular behavior, at least not within the next six months [in other words, there is]
no intention to take action” (Pender, Murdaugh, & Parsons, 2011, p. 51). Ten months ago I had
a surgical procedure on my foot that forced me to be off work for nine weeks and decreased my
activity and mobility dramatically. It was during this time that I was in this stage of the model.
Even though I acknowledged that was in fact overweight, my health condition prevented me
from making the appropriate changes to achieve a healthy weight.
The contemplation stage is when “an individual is seriously thinking about quitting or
adopting a particular behavior in the next six months” in other words there is intent to change
(Pender, Murdaugh, & Parsons, 2011, p. 51). Right after I returned to work from my surgical
procedure, which was in early March, I was at this stage. I knew that I had gained some weight
after the procedure, and I was thinking about what I needed to do to lose the weight plus extra to
obtain a healthy weight.
The planning or preparation stage is when “an individual is seriously thinking about
engaging in the contemplated change within the next month and has taken some steps in this
direction, [in other words the individual is] making small or sporadic changes” (Pender,
Murdaugh, & Parsons, 2011, p. 51). I was in this stage for less than a day. It so happened that
one day at work I heard one of my colleagues say that she had lost 30 pounds doing the online
Weight Watchers program. This colleague was looking and feeling great. I decided at that
moment that I would research the Weight Watchers program when I arrived home from work
that night.
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The action stage is when “the individual has made the behavior change and it has
persisted for less than six months, [in other words, the individual is] actively engaged in behavior
change” (Pender, Murdaugh, & Parsons, 2011, p. 51). This is the stage that I am in right now.
The same day that I came home from work and researched Weight Watchers I drastically joined
and began that same day. This occurred in the beginning of August, which was approximately
three weeks prior to the assignment of this paper. Currently, I have been actively participating in
the Weight Watchers program for nine full weeks and follow the plan religiously every day.
The maintenance stage is when “the change has been in place for at least six months and
is continuing, [in other words the individual is] sustaining the change over time” (Pender,
Murdaugh, & Parsons, 2011, p. 51). I plan to enter this stage of the model in early February of
2013. At that point, I will have been following the Weight Watchers program for six months, my
goal weight should be obtained, and my healthy eating habits will be sustained.
Wellness Nursing Diagnosis
Based on the personal assessment and the results of the health promotion tools, the
wellness nursing diagnosis that best fits my health promotion plan is effective therapeutic
regimen management defined as a “patterns of regulating and integrating into daily living a
program for treatment of illness and its sequelae that is satisfactory for meeting specific health
goals” (Ackley & Ladwig, 2008, p. 816). The defining characteristic that best fits my situation is
“appropriate choices of daily activities for meeting the goals of a prevention program” (Ackley
& Ladwig, 2008, p. 816). My short-term goals are to engage in healthy eating and exercising
habits which will result in weight loss and to obtain a weight of 120 pounds which would result
in a BMI of 21.5. My long-term goal is to maintain healthy eating habits to maintain a healthy
weight and lifestyle.
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Interventions
The interventions that are actively in place to achieve both the short-term and long-term
goals are 1) that I have joined Weight Watchers and follow their points plus program which
includes exercise at least five times a week and daily food tracking, 2) weigh myself weekly to
monitor the progress, and 3) purchase and prepare foods that will promote healthy eating and
weight loss so there is no temptation to stray from the plan. The Weight Watchers plan places a
point value on all food and drink consumed and activity performed. My plan allows me to
consume up to 26 points of food and drink per day with a cushion of 49 points per week for
extras and special occasions. I have a goal of achieving at least 21 points of activity per week.
The table in appendix E shows the points I have used for food and drink each day and the
activity points earned for each week for the past nine weeks along with the weight loss for those
weeks. As indicated by the table, the majority of the days I have remained within my limits of
food and drink points. However, there is room for improvement in regards to achieving 21 points
per week of activity. My weight loss is steady and consistent overall with an average weight loss
of 1.5 pounds per week. Slow and steady weight loss is the key to successful, long-term weight
loss and maintenance.
As far as my food purchasing and preparing is concerned, I purchase more fresh fruits
and vegetables and less packaged meals. I consume a minimum of seven servings of combined
fresh fruits and vegetables each day which helps to curb my incessant sweet tooth that I am
blessed with. I have replaced the majority of red meat purchases with white meat such as pork
and ground turkey instead of hamburger and steaks. These small food changes have not only
forced me to eat healthier, but it has also forced my family to eat healthier.
Results of Health Promotion Plan
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As a result of this effective health promotion plan, I have lost a total of 17 pounds, but
that does not describe the actual effects that I feel. Even though Rosenberg’s self-esteem scale
did not indicate I had low self-esteem, I feel much better about myself. I am not ashamed of
myself anymore as I was when I was considered overweight. I also have more energy and
stamina and enjoy my exercise workouts. As each week goes by, I become more and more
determined to obtain my goal weight and maintain my healthy eating habits. I can see that I am
setting a good example for my family, and I only hope that my patients can see that I am setting
a good example for them. Following this plan can get difficult at times when my husband wants
to take me out to eat, but I persevere and choose foods that will promote healthy eating.
Conclusion
Nurses have a very important role in patients’ lives when it comes to their health. Nurses
have the most direct contact and opportunities to encourage healthy lifestyle and provide the
education needed for the patients to obtain a healthy lifestyle. It is of vast importance that the
nurses also utilize this knowledge and expertise in their own personal lives to maintain a healthy
lifestyle. I was able to personally assess my own lifestyle prior to this assignment and take the
necessary steps to make changes to achieve good health. The results of these changes have made
me a better nurse and caretaker of my family by promoting healthy eating and lifestyle. I feel so
much better about myself, and I am proud of my accomplishments. The change was not
completely easy; therefore, I can empathize with others, including my patients, who are being
challenged by similar situations. I will utilize my change and progress to encourage others that
although change is difficult, determination and dedication are very powerful tools to achieving
one’s goals.
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References
Ackley, B. J. & Ladwig, G. B. (2008). Nursing diagnosis handbook: An evidence-based guide to
planning care (8th ed. ). St. Louis, MO: Mosby, Elsevier.
Body mass index (BMI). (2005). Cambridge dictionary of human biology and evolution.
Retrieved from http://credoreference.com/entry/cuphbe/body_mass_index_bmi
Pender, N., Murdaugh, C, & Parsons, M. A. (2011). Health promotion in nursing practice (6th
ed.). Upper Saddle River, NJ: Pearson.
Self-Esteem. (2001). Encyclopedia of women and gender: Sex similarities and differences and
the impact of society on gender. Retrieved from
http://www.dredoreference.com/entry/estwomen/self_esteem
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Appendix A
Health Beliefs Survey
The questionnaire is designed to determine the way in which different people view
certain important health-related issues. Each item is a belief statement, with which you
may agree or disagree. Beside each statement is a scale that ranges from strongly
disagree (1) to strongly agree (6). For each item, choose the number that represents the
extent to which you disagree or agree. This is a measure of your personal beliefs;
obviously, there are no right or wrong answers.
Please answer these items carefully, but do not spend too much time on any one item.
As much as you can, try to respond to each item independently. When making your
choice, do not be influenced by your previous choices. It is important that you respond
according to your actual beliefs and not according to how you feel you should believe or
how you think we want you to believe.
1 - Strongly Disagree; 2 - Moderately Disagree; 3 - Slightly Disagree; 4 - Slightly Agree;
5 - Moderately Agree; 6 - Strongly Agree
1
2
3
4 5
1. If I get sick, it is my own behavior that determines how
soon I will get well again.
2. No matter what I do, if I am going to get sick, I'll get sick.
x
3. Having regular contact with my physician is the best way
for me avoid illness.
x
4. Most things that affect my health happen to me by
accident.
5. Whenever I don't feel well, I should consult a medically
trained professional.
6
x
x
x
6. I am in control of my health.
x
7. My family has a lot to do with my becoming sick or staying
healthy.
x
8. When I get sick, I am to blame.
x
9. Luck plays a big part in determining how soon I will recover
from an illness.
10. Health professionals control my health.
x
x
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11. My good health is largely a matter of good fortune.
12. The main thing that affects my health is what I myself do.
13. If I take care of myself, I can avoid illness.
x
14. When I recover from illness, it's usually because other
people have been taking good care of me. (doctor, nurses,
family)
15. No matter what I do, I'm likely to get sick.
16. If it's meant to be, I will stay healthy.
17. If I take the right actions, I can stay healthy.
18. Regarding my health, I can only do what my doctor tells
me to do.
x
x
x
x
x
x
x
These three subscales, and the items included in each, are as follows:



Internal Items: 1, 6, 8, 12, 13, 17
Chance Items: 2, 4, 9, 11, 15, 16
Powerful-others items: 3, 5, 7, 10, 14, 18
The score on each subscale is the sum of the values for each item in that subscale
multiplied by 2. Scores within each subscale can range from 12 to 72. The higher the
score on the internal subscale, the more personal control clients believe that they
exercise over their own health. The higher the scores on the chance subscale and
power-others subscale, the higher the beliefs in the importance of chance and others
respectively in controlling personal health. Normative means for adults on each
subscale are as follows:
Internal, 50.4
Chance, 31.0
Powerful-others, 40.9
My score:
Internal: 62
Chance: 32
Powerful-others: 32
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Appendix B
Calculate Your Body Mass Index
Body mass index (BMI) is a measure of body fat based on height and
weight that applies to adult men and women.

Enter your weight and height using standard or metric measures.

Select "Compute BMI" and your BMI will appear below.
Español
Your
Height:
BMI Categories:
5
(feet)
Your
Weight:

Underweight = <18.5

Normal weight = 18.5–24.9

Overweight = 25–29.9

Obesity = BMI of 30 or
greater
2.5
(inches)
148
(pounds)
The BMI Tables
Aim for a Healthy
Weight:
Your BMI:

Limitations of the BMI

Assessing Your Risk

Controlling Your Weight
26.6

Recipes
Download the BMI
Calculator iPhone
App
Note: If this does not work
with your browser or for a
text alternative to this page,
go to our CGI-based BMI
Calculator.
http://nhlbisupport.com/bmi/
HEALTH PROMOTION PLAN
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Appendix B (cont)
Calculate Your Body Mass Index
Body mass index (BMI) is a measure of body fat based on height and
weight that applies to adult men and women.

Enter your weight and height using standard or metric measures.

Select "Compute BMI" and your BMI will appear below.
Español
Your
Height:
5
(feet)
Your
Weight:
BMI Categories:

Underweight = <18.5

Normal weight = 18.5–24.9

Overweight = 25–29.9

Obesity = BMI of 30 or
greater
2.5
(inches)
131
(pounds)
The BMI Tables
Aim for a Healthy
Weight:
Your BMI:

Limitations of the BMI

Assessing Your Risk

Controlling Your Weight
23.6

Recipes
Download the BMI
Calculator iPhone
App
Note: If this does not work
with your browser or for a
text alternative to this page,
go to our CGI-based BMI
Calculator.
http://nhlbisupport.com/bmi
HEALTH PROMOTION PLAN
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Appendix C
Your Body Mass Index (BMI)
26.2
click to read more
Your Body Shape (Waist To Height Ratio)
0.51
click to read more
Your Body Mass Index (BMI) is: 26.2 (weight of 148 pounds)
A BMI of 18.5 to 24.9 is considered healthy for adults. A BMI of 25 to 29.9 is considered overweight, while a BMI of
30 and above is considered obese. People with BMIs of 18.5 or less are considered underweight.
Learn More about BMI and your health.
Your Waist-to-Height Ratio is: 0.51
Your Body Shape Indicates: Increased Risk
A waist-to-height ratio under .50 is generally considered healthy. This ratio may give a more accurate assessment of
health for people who are muscular or for women who have a "pear" rather then an "apple" body shape.
HEALTH PROMOTION PLAN
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Be Careful: You have a thin shape and you may need to gain weight.
Healthy: You have a healthy shape!
Increased Risk: This measurement indicates a "pear" body shape. Excess fat is stored around the hips and thighs,
which is less harmful to health than fat stored around the belly (an apple shape).
Take Action: This measurement indicates an "apple" body shape. Excess fat stored in the stomach area increases
your risk of serious conditions such as heart disease, stroke, type 2 diabetes, and some types of cancer.
http://www.webmd.com/diet/calc-bmi-plus
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Appendix C (cont)
Your Body Mass Index (BMI)
23.2
click to read more
Your Body Shape (Waist To Height Ratio)
0.44
click to read more
Your Body Mass Index (BMI) is: 23.2 (weight of 131 pounds)
A BMI of 18.5 to 24.9 is considered healthy for adults. A BMI of 25 to 29.9 is considered overweight, while a BMI of
30 and above is considered obese. People with BMIs of 18.5 or less are considered underweight.
Learn More about BMI and your health.
Your Waist-to-Height Ratio is: 0.44
Your Body Shape Indicates: Healthy
A waist-to-height ratio under .50 is generally considered healthy. This ratio may give a more accurate assessment of
health for people who are muscular or for women who have a "pear" rather then an "apple" body shape.
HEALTH PROMOTION PLAN
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Be Careful: You have a thin shape and you may need to gain weight.
Healthy: You have a healthy shape!
Increased Risk: This measurement indicates a "pear" body shape. Excess fat is stored around the hips and thighs,
which is less harmful to health than fat stored around the belly (an apple shape).
Take Action: This measurement indicates an "apple" body shape. Excess fat stored in the stomach area increases
your risk of serious conditions such as heart disease, stroke, type 2 diabetes, and some types of cancer.
http://www.webmd.com/diet/calc-bmi-plus
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Appendix D
>> Rosenberg's Self-Esteem Scale (at weight of 148 pounds)
STATEMENT
Strongly
Agree
Agree Disagree
Strongly
Disagree
1. I feel that I am a person
of worth, at least on an
equal plane with others.
3
2. I feel that I have a
number of good
qualities..
2
3. All in all, I am inclined to
feel that I am a failure.
3
4. I am able to do things as
well as most other people.
3
5. I feel I do not have much
to be proud of.
3
6. I take a positive attitude
toward myself.
3
7. On the whole, I am
satisfied with myself.
1
8. I wish I could have more
respect for myself.
0
9. I certainly feel useless at
times.
3
10. At times I think I am no
good at all.
3
Reset
Your score on the Rosenberg self-esteem scale is:
Scores are calculated as follows:

For items 1, 2, 4, 6, and 7:
Strongly agree = 3
24
.
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Agree = 2
Disagree = 1
Strongly disagree = 0

For items 3, 5, 8, 9, and 10 (which are reversed in valence):
Strongly agree = 0
Agree = 1
Disagree = 2
Strongly disagree = 3
The scale ranges from 0-30. Scores between 15 and 25 are within normal range; scores below
15 suggest low self-esteem.
http://www.wwnorton.com/college/psych/psychsci/media/rosenberg.htm
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Appendix D (cont)
>> Rosenberg's Self-Esteem Scale (at weight of 131 pounds)
STATEMENT
Strongly
Agree
Agree Disagree
Strongly
Disagree
1. I feel that I am a person
of worth, at least on an
equal plane with others.
3
2. I feel that I have a
number of good
qualities..
2
3. All in all, I am inclined to
feel that I am a failure.
3
4. I am able to do things as
well as most other people.
3
5. I feel I do not have much
to be proud of.
3
6. I take a positive attitude
toward myself.
3
7. On the whole, I am
satisfied with myself.
2
8. I wish I could have more
respect for myself.
0
9. I certainly feel useless at
times.
3
10. At times I think I am no
good at all.
3
Reset
Your score on the Rosenberg self-esteem scale is:
Scores are calculated as follows:

For items 1, 2, 4, 6, and 7:
Strongly agree = 3
25
.
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Agree = 2
Disagree = 1
Strongly disagree = 0

For items 3, 5, 8, 9, and 10 (which are reversed in valence):
Strongly agree = 0
Agree = 1
Disagree = 2
Strongly disagree = 3
The scale ranges from 0-30. Scores between 15 and 25 are within normal range; scores below
15 suggest low self-esteem.
http://www.wwnorton.com/college/psych/psychsci/media/rosenberg.htm
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Appendix E
Summary of Weight Watchers PointPlus Tracker
Week of
10/7-10/13
9/30-10/6
9/23-9/29
9/16-9/22
9/9-9/15
9/2-9/8
8/26-91
8/19-8/25
8/12-8/18
Sun.
Mon.
19
24
25
24
21
26
24
24
24
22
21
24
18
18
26
23
23
20
Points per day
Tue. Wed. Thur.
20
16
16
15
24
23
26
24
23
17
26
23
20
20
26
25
24
20
21
27
22
26
19
22
24
25
20
Fri.
Sat.
Activity
pts/wk
20
22
24
28
25
20
22
22
28
23
24
24
44
24
23
22
23
22
25
20
24
16
18
23
31
18
25
Weight
loss
(lbs)
0
2
2
0
2
1
2
1
3