Which best describes the primary purpose of both the health belief model HBM and health promotion model HPM models?

Credentials and background of the theorist

Nola J. Pender’s first encounter with professional nursing occurred at 7 years of age, when she observed the nursing care given to her hospitalized aunt. “The experience of watching the nurses caring for my aunt in her illness created in me a fascination with the work of nursing,” noted Pender (Pender, personal communication, May 6, 2004). This experience and her subsequent education instilled in her a desire to care for others and influenced her belief that the goal of nursing was to help people care for themselves. Pender contributes to nursing knowledge of health promotion through her research, teaching, presentations, and writings.

Previous author: Lucy Anne Tillett. The author wishes to express appreciation to Nola J. Pender for reviewing the chapter.

Pender was born August 16, 1941, in Lansing, Michigan. She was the only child of parents who advocated education for women. Family encouragement to become a registered nurse led her to the School of Nursing at West Suburban Hospital in Oak Park, Illinois. This school was chosen for its ties with Wheaton College and its strong Christian foundation. She received her nursing diploma in 1962 and began working on a medical-surgical unit and subsequently in a pediatric unit in a Michigan hospital (Pender, personal communication, May 6, 2004).

In 1964, Pender completed her baccalaureate in nursing at Michigan State University. She credits Helen Penhale, assistant to the dean, who streamlined her program for fostering her options for further education. As was common in the 1960s, Pender changed her major from nursing as she pursued her graduate degrees. She earned a master’s degree in human growth and development at Michigan State University in 1965. “The M.A. in growth and development influenced my interest in health over the human life span. This background contributed to the formation of a research program for children and adolescents,” stated Pender. She completed her PhD in psychology and education in 1969 at Northwestern University. Pender’s (1970) dissertation research investigated developmental changes in encoding processes of short-term memory in children. She credits Dr. James Hall, doctoral program advisor, with “introducing me to considerations of how people think and how a person’s thoughts motivate behavior.” Several years later, she completed master’s-level work in community health nursing at Rush University (Pender, personal communication, May 6, 2004).

After earning her PhD, Pender notes a shift in her thinking toward defining the goal of nursing care as the optimal health of the individual. A series of conversations with Dr. Beverly McElmurry at Northern Illinois University and reading High-Level Wellness by Halpert Dunn (1961) inspired expanded notions of health and nursing. Her marriage to Albert Pender, an Associate Professor of business and economics who has collaborated with his wife in writing about the economics of health care, and the birth of a son and a daughter provided increased personal motivation to learn more about optimizing human health.

In 1975, Pender published “A Conceptual Model for Preventive Health Behavior,” as a basis for studying how individuals made decisions about their own health care in a nursing context. This article identified factors that were found in earlier research to influence decision making and actions of individuals in preventing disease. Pender’s original Health Promotion Model (HPM) was presented in the first edition of her text, Health Promotion in Nursing Practice, which was published in 1982. Based on subsequent research, the HPM was revised and presented in a second edition in 1987 and in a third edition in 1996. The fourth edition of Health Promotion in Nursing Practice was co-authored by Pender, Carolyn L. Murdaugh (PhD), and Mary Ann Parsons (PhD) and published in 2002, and a fifth edition was published in 2006.

In 1988, Pender and colleagues conducted a study at Northern Illinois University, DeKalb, which was funded by the National Institutes of Health. Susan Walker, Karen Sechrist, and Marilyn Frank-Stromborg tested the validity of the HPM (Pender, Walker, Sechrist, & Stromborg, 1988). The research team developed the Health Promoting Lifestyle Profile, an instrument used to study the health-promoting behavior of working adults, older adults, patients undergoing cardiac rehabilitation, and ambulatory patients with cancer (Pender, Murdaugh, & Parsons, 2002). Results from these studies supported the HPM (Pender, personal communication, July 19, 2000). Subsequently, more than 40 studies tested the predictive capability of the model for health-promoting lifestyle, exercise, nutrition practices, use of hearing protection, and avoidance of exposure to environmental tobacco smoke (Pender, 1996; Pender, Murdaugh, & Parsons, 2002).

Pender provided leadership in the development of nursing research in the United States. Her support of the National Center for Nursing Research in the National Institutes of Health was instrumental to its formation. She has promoted scholarly activity in nursing through involvement with Sigma Theta Tau International, as president of the Midwest Nursing Research Society from 1985 to 1987, and as chairperson of the Cabinet on Nursing Research of the American Nurses Association. She has served as a Trustee of the Midwest Nursing Research Society since 2009 (nursing.umich.edu/faculty-staff/nola-j-pender). Inducted as a fellow of the American Academy of Nursing in 1981, she served as President of the Academy from 1991 until 1993. In 1998, she was appointed to a 4-year term on the U.S. Preventive Services Task Force, an independent panel charged to evaluate scientific evidence and to make age-specific and risk-specific recommendations for clinical preventive services (nursing.umich.edu/faculty-staff/nola-j-pender).

As a leader in nursing education, Dr. Pender guided many students and mentored others. Over her 40 years as an educator, she facilitated the learning of baccalaureate, masters, and PhD students. She has mentored a number of postdoctoral fellows. In 1998, the University of Michigan School of Nursing honored Pender with the Mae Edna Doyle Award for excellence in teaching. She is a Distinguished Professor at Loyola University of Chicago School of Nursing.

A recipient of many awards and honors, Dr. Pender has served as a distinguished scholar at a number of universities. She received an honorary doctorate from Widener University in 1992. In 1988, she received the Distinguished Research Award from the Midwest Nursing Research Society for her contributions to research and research leadership, and in 1997 she received the American Psychological Association Award for outstanding contributions to nursing and health psychology. Her widely used text, Health Promotion in Nursing Practice (Pender, Murdaugh, & Parsons, 2002), was the American Nurses Association Book of the Year for contributions to community health nursing (nursing.umich.edu/faculty-staff/nola-j-pender).

Pender was Associate Dean for Research at the University of Michigan School of Nursing from 1990 to 2001. In this position, she facilitated external funding of faculty research, supported emerging centers of research excellence in the School of Nursing, promoted interdisciplinary research, supported translating research into science-based practice, and linked nursing research to formulation of health policy (nursing.umich.edu/faculty-staff/nola-j-pender). A child and adolescent health behavior research center initiated at the University of Michigan in 1991 represents Pender’s efforts to build a large interdisciplinary research team to study and influence the health-promoting behaviors of individuals by understanding how these behaviors are established in youth (Pender, personal communication, May 24, 2000). Her program of research includes two major foci: 1.) Understanding how self-efficacy effects the exertion and affective (activity-related affect) responses of adolescent girls to the physical activity challenge; and, 2.) Developing an interactive computer program as an intervention to increase physical activity among adolescent girls. The Design of a Computer Based Physical Activity Counseling Intervention for Adolescent Girls was a research program led by Dr. Lorraine Robbins (Robbins, Gretebeck, Kazanis, & Pender, 2006).

Pender has published numerous articles on exercise, behavior change, and relaxation training as aspects of health promotion and has served on editorial boards and as an editor for journals and books. Pender is recognized as a scholar, presenter, and consultant on health promotion. She has consulted with nurse scientists in Japan, Korea, Mexico, Thailand, the Dominican Republic, Jamaica, England, New Zealand, and Chile (N. Pender, curriculum vitae 2000; Pender, Murdaugh, & Parsons, 2006). Her book is now available in the Japanese and Korean languages (Pender, 1997a, 1997b). Dr. Pender continues influencing the nursing profession by providing leadership as a consultant to research centers and providing early scholar consultation (nursing.umich.edu/faculty-staff/nola-j-pender). As a nationally and internationally known leader, Pender speaks at conferences and seminars. She collaborates with the editor of the American Journal of Health Promotion, advocating for legislation to fund health promotion research (Pender, personal communication, May 6, 2004).

Pender’s future plans include travel to offer consultation and her speaking opportunities. She engages in some graduate teaching, including courses on theories of nursing and scientific writing as a Distinguished Professor at Loyola University in Chicago (Pender, personal communication, February 27, 2008). She continues active mentoring through e-mail exchanges with scholars beginning research programs (Pender, personal communication, May 6, 2004).