File Name: behavior theory in health promotion practice and research modifier.zip
Once production of your article has started, you can track the status of your article via Track Your Accepted Article. Help expand a public dataset of research that support the SDGs. Founded in by Ernst Wynder, Preventive Medicine is an international scholarly journal that publishes original articles on the science and practice of disease prevention , health promotion , and public health policymaking.
Once production of your article has started, you can track the status of your article via Track Your Accepted Article. Help expand a public dataset of research that support the SDGs. Founded in by Ernst Wynder, Preventive Medicine is an international scholarly journal that publishes original articles on the science and practice of disease prevention , health promotion , and public health policymaking. Preventive Medicine aims to reward innovation.
Quantitative Research Journal Pdf
An essential characteristic of advanced practice nurses is the use of theory in practice. Clinical nurse specialists apply theory in providing or directing patient care, in their work as consultants to staff nurses, and as leaders influencing and facilitating system change. Knowledge of technology and pharmacology has far outpaced knowledge of how to facilitate health behavior change, and new theories are needed to better understand how practitioners can facilitate health behavior change.
In this article, the Integrated Theory of Health Behavior Change is described, and an example of its use as foundation to intervention development is presented. The Integrated Theory of Health Behavior Change suggests that health behavior change can be enhanced by fostering knowledge and beliefs, increasing self-regulation skills and abilities, and enhancing social facilitation.
Engagement in self-management behaviors is seen as the proximal outcome influencing the long-term distal outcome of improved health status. Person-centered interventions are directed to increasing knowledge and beliefs, self-regulation skills and abilities, and social facilitation.
Using a theoretical framework improves clinical nurse specialist practice by focusing assessments, directing the use of best-practice interventions, and improving patient outcomes. Using theory fosters improved communication with other disciplines and enhances the management of complex clinical conditions by providing holistic, comprehensive care.
Personal behavior influences one's health. Persons with chronic conditions improve their health by managing specific health behaviors, a process that requires behavior change. Healthy people, as well as persons with chronic conditions, have opportunities to improve their health by regularly engaging in health promotion activities, a behavior change process similar or identical to the process used to manage chronic conditions.
For example, just as persons with pulmonary conditions who smoke need to change their behavior, healthy people who smoke may also need to change their behavior. Nurses and other healthcare professionals play a major role in identifying behaviors critical to health, assessing the needs of individuals and groups and recommending specific health behaviors, preparing and delivering interventions designed to enhance engagement in health behaviors, and evaluating the effectiveness of interventions for individuals, groups, communities, and the nation.
To fulfill these role responsibilities, nurses and other healthcare professionals benefit from understanding the theory and science of health behavior change, what is known as well as the gaps and opportunities. Knowledge development and use are best when built on the success of the past.
This article includes a discussion of select aspects of health behavior change; introduces the ITHBC, including concepts, definitions, and relationships among concepts; and provides an example of how the ITHBC was used to develop an intervention designed to facilitate a specific change. However, persons and their families are often not prepared to assume this responsibility. Repeated readmission to acute care facilities, 6 , 7 failure to reach targeted outcomes, 8 , 9 and the continued need for unscheduled outpatient services 10 are indicators that people need more help.
Healthcare systems are being challenged to assume a greater role in assisting persons to better care for themselves. Health behaviors required to manage chronic conditions are numerous and varied. Persons self-administer prescribed and over-the-counter medications.
Health behaviors needed to manage medications include having and using resources to obtain the medications; accurately self-administering medications over time; and recognizing and reporting adverse effects, unintended outcomes, or failure to attain desired outcomes.
Persons must know how to monitor and make decisions about disease indicators such as blood glucose, peak flow reading, or weight gain. People who successfully manage chronic conditions manage negative emotions associated with chronic conditions and fulfill responsibilities to their concomitant life roles.
Health promotion also requires people to initiate and maintain health behavior changes. Commonly recognized behaviors such as activity and exercise, good nutrition, stress management, limited alcohol consumption, and smoking cessation positively affect health. Prevention behaviors include things such as screening for breast cancer, 27 applying preventative strategies for bone loss during menopausal transition and with age, 28 or obtaining immunization for prevention of human papillomavirus infection.
Although the value of engaging in health-promoting activities is generally accepted, there is significant variability in how primary health promotion is incorporated into the healthcare system, schools, the work-place, and communities.
The discovery of knowledge about diseases, technological assessments, and pharmacology has far outpaced the knowledge of how to help people incorporate healthcare advances into their daily lives. Healthcare professionals need to better understand how health behavior change is made and their role in facilitating and supporting change. How do people make health behavior change that persists over time?
In the distant past, many acutely ill persons were encouraged and expected to assume a passive sick role. People and their families are taught how to manage chronic conditions. Some people and families successfully managed, but many did not. Health promotion was viewed as optional. Encouragement to engage in healthy behaviors was not always included in routine care; some healthcare professionals and systems embraced it, many others did not. When included in care settings, health promotion efforts tended to focus on single behaviors for individuals.
General health was a fragmented concept, and information was modular and condition specific. New approaches to health promotion 39 are directed to both individuals and populations, focus on multiple behaviors simultaneously, are delivered by professionals and laypersons, 40 are increasingly sensitive to issues of culture and age, 41 and occur across a variety of settings including schools, churches, and worksites.
Contemporary interest in health promotion ranges from optimization of an individual's genetic makeup 42 to construction of the health-promoting community's physical environments. Four decades of research related to health behavior produced a better understanding of health behavior change. Changing one's health behaviors is a more complex process than originally envisioned. New health behaviors often are not maintained. Outcomes that have been achieved in controlled research studies have not been realized clinically.
Healthcare providers overestimate the extent to which people change. Healthcare systems regularly monitor treatment especially cost and appropriateness and outcomes, but the relationships between people's use of prescribed treatment and outcomes are seldom included in cost-benefit analysis. Self-reports of behavior are the most extensively used measure of engagement in health behavior. Self-report is accessible and inexpensive; however, it presents the perspective of the individual, a critical but limited picture.
There is a lack of support for a number of previously held assumptions about health behavior change. For example, regardless of the behavior, the highest rate of relapse is seen very early after the change, and this has been seen across dieting, smoking cessation, increasing calcium intake, and others.
According to Whitehead, 68 there is strong consensus for health promotion among nurses. And although there is a general understanding of health promotion, nurses struggle with understanding theoretical perspective related to health behavior change, best approaches, and evaluation of outcomes.
Theory, specifically midrange theory, is useful because it provides an explanation of various situations and phenomenon. Although a great deal has been learned about health behavior change, challenges to nurses and other healthcare professionals are increasing. New theories are needed, theories building on past conceptual and empirical work. In contrast to the grand theories of nursing, midrange or middle-range, theories are more concrete and more easily used to guide practice.
Midrange theories are designed to be used in practice. There are numerous opportunities for advanced practice nurses APNs to use midrange theory while providing and directing clinical care. Using midrange theory can assist with the transfer, application, and evaluation of knowledge across individual and groups of patients. An essential characteristic of APNs is use of theory in practice. Theory-based practice enhances achievement of positive patient outcomes. Theory-based practice helps clinicians be faster as it focuses their assessment.
It fosters a match between the theory and evidence-based interventions and outcomes with existing, sensitive measures. Using theory decreases distractions and reduces time obtaining and sorting irrelevant information. It facilitates clear and timely communication with other professionals and interested parties eg, health plan or insurance.
Using theory is smart practice. Clinicians are able to observe patterns more quickly, manage complexity, and provide or direct holistic care. Using theory helps ensure that a CNS practice is holistic and comprehensive. Rather than focusing on any single behavior or theory, components of interventions or programs were selected because of their efficacy defined as statistically significant differences between groups. During her postdoctoral fellowship T32NR , Ryan developed the ITHBC by integrating those concepts that had been foundational to interventions previously identified.
The interventions that resulted in changing health behaviors were influenced by a number of theories, including theories of health behavior change, 12 , 18 , 44 — 49 , 51 , 61 — 65 , 73 — 78 self-regulation theories, 79 — 85 social support theory, 12 , 53 , 63 , 64 , 67 , 73 , 75 , 76 , 86 — 88 and research related to self-management of chronic illnesses. There is strong empirical evidence for the inclusion of each of the concepts, and it is the proposed relationship among the concepts that is new in this descriptive midrange theory.
New theories are needed to better understand health behavior change. Desire and motivation are prerequisites to change, and self-reflection facilitates progress. Positive social influences sway one's interest and willingness just as positive relationships help to support and sustain change. There is growing evidence that person-centered interventions are more effective than standardized interventions in facilitating health behavior change.
The ITHBC Figure 1 purports health behavior change can be enhanced by fostering knowledge and beliefs, increasing self-regulation skills and abilities, and enhancing social facilitation.
Engagement in self-management behaviors is seen as the proximal outcome, and this, in turn, influences the long-term outcome of improved health status. According to this theory, persons will be more likely to engage in the recommended health behaviors if they have information about and embrace health beliefs consistent with behavior, if they develop self-regulation abilities to change their health behaviors, and if they experience social facilitation that positively influences and supports them to engage in preventative health behaviors.
Outcomes in this theory are both proximal and distal. The proximal outcome is actual engagement in self-management behaviors specific to a condition or health behavior.
Distal outcomes refer to the long-term impact of personal behavior on health status. Failure to engage in healthy behaviors may result in premature onset of disease conditions.
Distal outcomes are related, in part, to successful achievement of proximal outcomes. Although achievement of distal outcomes provides data about the effectiveness of the intervention, these outcomes are generally slow to be realized.
Measurement of proximal outcomes is critical to evaluate whether people have made and are maintaining change in their health behavior. The constructs of knowledge and beliefs, self-regulation, and social facilitation are related to each other and to the proximal and distal outcomes. Knowledge and beliefs are the first construct. Knowledge is defined as condition-specific factual information, and beliefs are defined as personal perceptions about the specific health condition or health behavior.
Enhancement of knowledge and beliefs results in increased understanding of a specific condition or behavior, increased behavior-specific self-efficacy confidence in one's ability to successfully engage in a change in normal and stressful situations , outcome expectancy one's belief that engagement in a behavior will result in desired results , and goal congruence resolution of confusion and anxiety occurring from apparent contradictory and competing demands associated with health goals.
The second major construct is self-regulation. Self-regulation is a process that people use as they incorporate a behavior change into their daily routines and lifestyles. Self-regulation requires goal setting, self-monitoring and reflective thinking, decision making, planning and plan enactment, self-evaluation, and management of emotions occurring with the change. The third major construct is social facilitation. Social facilitation includes social influence and social support.
People experience social influence when a knowledgeable person in a position of perceived authority sways their thinking and motivation, leading to engagement in behavior. Social influence comes from numerous sources, for example, healthcare providers, television and radio, family and neighbors, coworkers, or printed or electronic communication. Social support consists of emotional, instrumental, or informational support, which facilitates engagement in a health behavior.
Advanced Search. In health education and health promotion an ideal theory is one that is exclusive to health behaviors, predicts health behavior change, is based on empirical evidence with health behavior changes, provides enough predictive power, is parsimonious, has constructs that are malleable, caters to both one-time and long-term health behavior change, works at individual, group and community levels, and is applicable across cultures. Such a new theory will address both initiation and sustenance of health behavior change, will incorporate cognitive, conative, and environmental empirically tested components from existing theories, will be parsimonious, applicable at individual, group and community levels, will be culturally robust and useful for resource-scarce settings. Another problem has been that the constructs of the HBM do not all carry equal value. Further, Ogden has criticized the conceptual basis of HBM.
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Seth M. Noar, Rick S. Zimmerman, Health Behavior Theory and cumulative knowledge regarding health behaviors: are we moving in the right direction? Although research on Health Behavior Theory HBT is being conducted at a rapid pace, the extent to which the field is truly moving forward in understanding health behavior has been questioned. This issue is examined in the current article.
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Journal of Education and Health Promotion is a peer-reviewed online journal with Continues print on demand compilation of issues published. Users Online: Latest published articles. Eliciting preferences of professors and medical group students for evaluation methods of theoretical courses: An application of discrete choice experiment analysis. This study aimed to elicit preferences
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