Running head: HEALTH PROMOTION PLAN 1
Health Promotion Plan
Jordan Furstenau
Ferris State University
Running head: HEALTH PROMOTION PLAN 2
Abstract
The purpose of this paper is to demonstrate the application of the Transtheoretical Model (TM)
to a health promotion plan focused on weight loss and increased wellness. Each stage of the TM
is evaluated and applied to the health promotion plan. Several instruments were used to develop
a successful health promotion plan including a sleep study, body mass index (BMI) calculator,
health benefits surveys, as well as a diet journal. The author provides a wellness diagnosis and
includes both short and long terms goals for success.
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Health Promotion Plan
A health promotion plan was developed in order to facilitate a successful lifestyle change
that was beneficial to the author. The plan incorporated several instruments that were used to
encourage the understanding of current dietary habits, sleeping habits, health beliefs, and BMI.
The results from each instrument are provided and accurately depict the author’s habits and
beliefs in regards to his health. The TM can be used to promote healthy practices. The TM
involves behavioral change and involves five stages including precontemplation, contemplation,
planning/preparation, action, and maintenance (Pender et al., 2011). All five stages were
assessed in regards to the author’s health habits and related to his health promotion plan. It is
important to know and understand what the human body requires in order to maintain health.
Based on results from the health benefits survey as well as the other instruments used by the
author, the wellness diagnosis developed was readiness for enhanced education r/t nutritional
habits.
Health Promotion Instruments
Instruments can be used to assess lifestyle habits and beliefs in regards to health. There
were four health promotion instruments utilized in the health promotion plan. The health beliefs
survey was used to assess the author’s current state of mind in regards to his own health. The
sleep study was used to assess his current sleeping habits and look for areas of needed
improvement. The BMI calculator was used to evaluate and provide evidence to the required
change in dietary habits. Finally, the diet journal was used to assess the lack of nutrients and
prevalence of unnecessary fats and carbohydrates in the author’s diet over a two week period.
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Health Beliefs Survey
The results from the health beliefs survey (Appendix A) were not very close to the
normative means. The author had a very high level of internal meaning. The author tends to
believe that health is heavily influenced by the individual and that he has a powerful influence
over his own health. The other two categories of chance and others were well below the
normative means. The personal health beliefs of the author reflect a sense of accountability for
his current state of health. This sense of accountability along with the need for increased
education was used to choose additional instruments. In order for the author to improve his
current state of health, an understanding of what influences health was required. Through the use
of a BMI calculator, a sleep study, and dietary study the author was able to learn what he needed
to do to improve his health as well as how he could do it.
Additional Health Promotion Instruments
The author decided to use a sleep time questionnaire to evaluate his own sleeping habits.
The questionnaire provided useful data to support the fact that the author was not getting a
healthy amount of sleep. Sleep is necessary in order for survival and its implications on the
human body are endless. While the author tried to balance school, work, and family life he often
felt tired and stressed. Seven to eight hours of sleep is a minimum sleep requirement for optimal
health and the author was able to use the sleep time questionnaire to conclude that he was not
getting a sufficient amount of sleep.
The author used a body mass index (BMI) index chart for adults (Appendix C) to
conclude that he was considered overweight. The author’s height was 71 inches and his weight
was 200 pounds. This translated into a BMI of 28 which is considered overweight. Studies have
proven that there is a direct correlation between BMI and disease risk, as the BMI increases so
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does the risk for disease (Pender et al., 2011). The disease risk related to overweight men under
the age of forty years old is increased with a BMI from 25-30.
The diet journal (Appendix D) was used to identify the nutrition of the author’s most
current diet. Effective planning for health promotion requires evaluation of the nutritional status
of the individual (Pender et al., 2011). The journal was used for a span of two weeks. The
purpose was to identify areas for diet improvement in order to decrease the BMI associated with
an overweight author. The author was able to identify two serious diet insufficiencies. The author
was eating foods that were too high in fats and not eating enough vegetables and fruits. The
author’s diet was relatively balanced but not considered healthy. In two weeks the author ate two
portions of vegetables and everyday ate foods containing a high amount of fat. Often the diet did
not have enough variety. Although the author did not waste much food during the two week
period, he was not able to eat a variety of healthy items. The author needed to eat less fatty foods
and carbohydrates and more vegetables and fruits.
Transtheoretical Model
The health promotion plan developed by the author can be described as a process through
the Transtheoretical Model (TM). The TM is derived from psychotherapy and theories of
behavioral change and is an integrative framework to describe how individuals progress towards
adopting a behavior change (Pender et al., 2011). Procontemplation is the first stage and the
author had already gone through this stage. Before entering the healthcare field the author had no
interest in his diet as it pertained to his health. As a nurse working in the healthcare field, the
author has long been contemplating a behavioral change. This is the second stage of the TM and
implies the intent to change. The TM focuses on the idea of perception and that by changing the
subject’s perception a change in behavior will also occur (Robinson & Vail, 2012).
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The author realized that his intentions were congruent with the stage of planning.
According to Pender et al., the planning stage of TM is when an individual is seriously thinking
about engaging in the contemplated change within the next month and has taken steps in this
direction. Through the use of various health promotion instruments the author decided to take
action. The sleep study provided insight into the author’s lack of rest and need for a more
consistent sleep schedule. The consequences of inadequate sleep include increased stress,
increased risk for depression, and increased risk for illness (Chitty & Black, 2011). The author
was able to realize that he considered himself the most influential variable in his current state of
health. He participated in a diet journal in order to identify problems that contributed with his
overweight status provided by the BMI chart (Appendix C).
The next stage for the author is action. The action stage involves having made the
behavior change and it has persisted for less than six months (Pender et al., 2011). This stage will
require the knowledge and motivation to make serious lifestyle changes. The author will be
changing is diet and improving his wellness by following a healthy sleep schedule. After the
author has followed his health promotion plan, he would continue to live in the stage of
maintenance of the TM. The maintenance stage will have been completed after six months of
strict following of the health promotion plan. The author would commit to improving his health
and lowering his BMI.
Nursing Wellness Diagnosis
The most applicable nursing wellness diagnosis to the author’s health situation was
readiness for enhanced education r/t nutritional habits. It is unhealthy for anyone to consume as
many unhealthy foods daily as the author (Appendix D). It is important to know and understand
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what the human body needs and to replace unhealthy food with foods that are beneficial. By
knowing what the daily requirements are for diet and sleep the author would be able to create a
health promotion plan that is both effective and beneficial. The author must realize that stress
plays a huge factor in my eating habits. Stress is a potential threat to mental health and physical
well-being and is associated with several illnesses (Pender et al., 2011). A poor sleep schedule
can contribute to increased stress. The author must remain educated about healthy eating habits
and sleeping patterns in order to successfully complete his health promotion plan.
Personal Goals
The author developed several short term goals aimed at increasing his healthy lifestyle
choices and decreasing his poor habits. The author planned to continue a diet journal in order to
evaluate his food choices. The author planned to create a diet regime by following the food
pyramid, recommended by the World Health Organization (WHO) within two weeks. The author
designed a sleep pattern that he would commit to following. This schedule consists of setting a
set schedule for sleep time, awake time, as well as what time he would lay down for the night.
The author also planned to sign up for a nutrition class at Ferris State University in order to
complete a program requirement and to increase knowledge about diet.
The author developed several long term goals to successfully complete his health
promotion plan. The author committed to reaching a BMI score of less than 25 within 12 months
of the plan. The author committed to adjusting his sleep schedule in order to reach a minimum 8
hours sleep time per night. The timeframe for this goal is within eight months. The author must
use a personal calendar to help manage his time and allow for appropriate sleep time. The third
goal of the author is to commit to continuing to improve his health in other areas of his life. This
is a lifetime goal. Other areas of improvement include an exercise regime that is increases
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cardiovascular health and decreases stress and regular physician visits to validate the health
promotion plan and maintain a high level of wellness.
Conclusion
The author was able to create a health promotion plan that encouraged education and
healthy lifestyle choices. Through the stages of the TM, the author developed focus driven goals
that create a well-rounded plan. The author was able to use several different tools to identify and
overcome several health hindrances present in his life. The author developed a health promotion
plan that was driven by the results of the health beliefs survey in which the author was able to
take personal responsibility for his current state of health. Through completing his short and long
term goals the author will be able to increase his state of health and successfully complete his
health promotion plan.
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References
Chitty, K.K., & Black, B.P. (2011). Professional nursing: Concepts and challenges (6th ed.)
Maryland Heights, MO: Saunders
Pender, N.J., Murdaugh, C.L., & Parsons, M.A. (2011). Health Promotion in Nursing Practice.
(6th ed.). Upper Saddle River, NJ: Prentice-Hall.
Robinson, L.M., Vail, S.R. (2012). An integrative review of adolescent smoking cessation using
the transtheoretical model of change. Journal of Pediatric Health Care, 26(5), 336-345.
Retrieved September 4, 2012, from PubMed.
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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 61. If I get sick, it is my own behavior that determines how
soon I will get well again. x
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.
x
5. Whenever I don't feel well, I should consult a medically trained professional.
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 x
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from an illness.
10. Health professionals control my health. x
11. My good health is largely a matter of good fortune. x
12. The main thing that affects my health is what I myself do. x
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)
x
15. No matter what I do, I'm likely to get sick. x
16. If it's meant to be, I will stay healthy. x
17. If I take the right actions, I can stay healthy. x
18. Regarding my health, I can only do what my doctor tells me to do.
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
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My Results
Internal-64
Chance-26
Powerful/others-14
Appendix B
SLEEP TIMING QUESTIONNAIRE (STQ)
This questionnaire asks about when you normally sleep. We are interested in getting as accurate
a picture as we can of the times when you normally go to bed and get up. Please think
carefully before giving your answers and be as accurate and as specific as you can be. Please
answer in terms of a recent “normal average week,” not one in which you traveled,
vacationed or had family crises. Thanks.
Please think of GOOD NIGHT TIME as the time at which you are finally in bed and
trying to fall asleep.
On the night before a work day or school day,
what is your earliest GOOD NIGHT TIME ? 10pm
On the night before a work day or school day,
what is your latest GOOD NIGHT TIME ? 12:30am
On the night before a work day or school day,
what is your usual GOOD NIGHT TIME ? 11pm
How stable (i.e., similar each night) are your GOOD NIGHT TIMES before a work day or
school day? (circle one)
0-15mins. 16-30mins. 31-45mins. 46-60mins.
61-75mins. 76-90mins. 91-105mins 106-120mins.
2-3hours 3-4hours over 4hours
On a night before a day off (e.g. a weekend),
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what is your earliest GOOD NIGHT TIME ? 11pm
On a night before a day off (e.g. a weekend),
what is your latest GOOD NIGHT TIME ? 1am
On a night before a day off (e.g. a weekend),
what is your usual GOOD NIGHT TIME 12am
How stable (i.e., similar each night) are your GOOD NIGHT TIMES on a night before a day
off (e.g. a weekend)? (circle one)
0-15mins. 16-30mins. 31-45mins. 46-60mins.
61-75mins. 76-90mins. 91-105mins 106-120mins.
2-3hours 3-4hours over 4hours
Please think of GOOD MORNING TIME as the time at which you finally get out of bed
and start your day.
Before a work day or school day,
what is your earliest GOOD MORNING TIME ? 6am
Before a work day or school day,
what is your latest GOOD MORNING TIME ? 7am
Before a work day or school day,
what is your usual GOOD MORNING TIME ? 6:15 am
How stable (i.e., similar each night) are your GOOD MORNING TIMES before a work day
or school day? (circle one)
0-15mins. 16-30mins. 31-45mins. 46-60mins.
61-75mins. 76-90mins. 91-105mins 106-120mins.
2-3hours 3-4hours over 4hours
Before a day off (e.g. a weekend),
what is your earliest GOOD MORNING TIME ? 8am
Before a day off (e.g. a weekend),
what is your latest GOOD MORNING TIME ? 11am
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Before a day off (e.g. a weekend),
what is your usual GOOD MORNING TIME ? 9am
How stable (i.e., similar each night) are your GOOD MORNING TIMES on a night before a
day off (e.g. a weekend)? (circle one)
0-15mins. 16-30mins. 31-45mins. 46-60mins.
61-75mins. 76-90mins. 91-105mins 106-120mins.
2-3hours 3-4hours over 4hours
These questions are about how much sleep you lose to unwanted wakefulness:
On most nights, how long, on average does it take you to fall asleep after you start trying?
_________30_____minutes
On most nights, how much sleep do you lose, on average, waking up during the night
(e.g. to go to the bathroom)?
_______0_______minutes
(Authors answers are either underlined or bold print)
http://www.journalsleep.org/Articles/260213.pdf
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Appendix C
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Appendix D
Journal of Daily Diet
Week 1 Monday Tuesday Wednesday Thursda Friday Saturday Sunday
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y
Breakfast Pop tart Cereal Cereal Pop tart Eggs
and
Bacon
No
breakfast
Cereal
Lunch Turkey
Sandwich
Burger
King
burger
Fish and
chips
Tacos Cereal Chinese
food
Chinese
Food
Dinner Pizza Pizza Tacos Tacos Pasta Pasta Turkey
Sub
Week 2 Monday Tuesday Wednesday Thursday Friday Saturday Sunday
Breakfast Apple Cereal Cereal Eggs and
Bacon
and Toast
Pizza Toast Waffles
Lunch Mcdonalds Peanut
Butter
Sandwich
Pizza Chips Chicken
and Rice
Spaghetti Chips
and
cheese
Dinner Ramon
noodles
Ramon
noodles
Pizza Chicken
and rice
Spaghetti Spaghetti cereal
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