Health Belief Model

It is a conceptual framework that describes a person's health behavior as an

expression of health beliefs. The model was designed to predict a person's
health behavior, including the use of health services, and to justify
intervention to alter maladaptive health behavior. Components of the model
include the person's own perception of susceptibility to a disease or
condition, the perceived likelihood of contracting that disease or condition,
the perceived severity of the consequences of contracting the condition or
the disease, the perceived benefits of care and barriers to preventive
behavior, and the internal or external stimuli that result in appropriate health
behavior by the person.
 Health Promotion Model

The health promotion model (HPM) proposed by Nola J Pender (1982; revised,
1996) 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.

The model focuses on following three areas:
· Individual characteristics and experiences
· Behavior-specific cognitions and affect
· Behavioral outcomes
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.

Precede – Proceed Model

The PRECEDE-PROCEED model 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. PRECEDE (P redisposing, R einforcing, and E nabling C onstructs
in E ducational D iagnosis and E valuation) outlines a diagnostic planning
process to assist in the development of targeted and focused public health
programs. PROCEED (P olicy, R egulatory, and O rganizational C onstructs in
E ducational and E nvironmental D evelopment) guides the implementation
and evaluation of the programs designed using PRECEDE.

PRECEDE consists of five steps or phases. Phase one involves determining

the quality of life or social problems and needs of a given population. Phase
two consists of identifying the health determinants of these problems and
needs. Phase three involves analyzing the behavioral and environmental
determinants of the health problems. In phase four, the factors that
predispose to, reinforce, and enable the behaviors and lifestyles are
identified. Phase five involves ascertaining which health promotion, health
education and/or policy-related interventions would best be suited to
encouraging the desired changes in the behaviors or environments and in
the factors that support those behaviors and environments.

PROCEED is composed of four additional phases. In phase six, the

interventions identified in phase five are implemented. Phase seven entails
process evaluation of those interventions. Phase eight involves evaluating
the impact of the interventions on the factors supporting behavior, and on
behavior itself. The ninth and last phase comprises outcome evaluation—that
is, determining the ultimate effects of the interventions on the health and
quality of life of the population.

In actual practice, PRECEDE and PROCEED function in a continuous cycle.

Information gathered in PRECEDE guides the development of program goals
and objectives in the implementation phase of PROCEED. This same
information also provides the criteria against which the success of the
program is measured in the evaluation phase of PROCEED. In turn, the data
gathered in the implementation and evaluation phases of PROCEED clarify
the relationships examined in PRECEDE between the health or quality-of-life
outcomes, the behaviors and environments that influence them, and the
factors that lead to the desired behavioral and environmental changes.
These data also suggest how programs may be modified to more closely
reach their goals and targets.