Table 3: Theoretical Foundations.
Nursing Theory:
Pender’s Health Promotion Model
Digital Educational Theory:
Sieman’s Connectivism
“Health-promoting behavior is the endpoint or action outcome directed toward attaining a positive health outcome such as optimal well-being, personal fulfillment, and productive living.”
Three focus areas in Pender’s HPM:
  1. Individual characteristics and experiences
  2. Behavior-specific cognitions and affect
  3. Behavioral outcomes
Thirteen theoretical statement are:
  1. Prior behavior and inherited and acquired characteristics influence beliefs, affect, and enactment of health-promoting behavior.
  2. Persons commit to engaging in behaviors from which they anticipate deriving personally valued benefits.
  3. Perceived barriers can constrain commitment to action, a mediator of behavior as well as actual behavior.
  4. Perceived competence or self-efficacy to execute a given behavior increases the likelihood of commitment to action and actual performance of the behavior.
  5. Greater perceived self-efficacy results in fewer perceived barriers to a specific health behavior.
  6. Positive affect toward a behavior results in greater perceived self-efficacy, which can in turn, result in increased positive affect.
  7. When positive emotions or affect are associated with a behavior, the probability of commitment and action is increased.
  8. Persons are more likely to commit to and engage in health-promoting behaviors when significant others model the behavior, expect the behavior to occur, and provide assistance and support to enable the behavior.
  9. Families, peers, and health care providers are important sources of interpersonal influence that can increase or decrease commitment to and engagement in health-promoting behavior.
  10. Situational influences in the external environment can increase or decrease commitment to or participation in health-promoting behavior.
  11. The greater the commitments to a specific plan of action, the more likely health-promoting behaviors are to be maintained over time.
  12. Commitment to a plan of action is less likely to result in the desired behavior when competing demands over which persons have little control require immediate attention.
  13. Persons can modify cognitions, affect, and the interpersonal and physical environment to create incentives for health actions.
“Connectivism presents a model of learning that acknowledges the tectonic shifts in society where learning is no longer an internal, individualistic activity. How people work and function is altered when new tools are utilized.”
Principles of Connectivism:
  • Learning and knowledge rests in diversity of opinions.
  • Learning is a process of connecting specialized nodes or information sources.
  • Learning may reside in non-human appliances.
  • Capacity to know more is more critical than what is currently known
  • Nurturing and maintaining connections is needed to facilitate continual learning.
  • Ability to see connections between fields, ideas, and concepts is a core skill.
  • Currency (accurate, up-to-date knowledge) is the intent of all connectivist learning activities.
  • Decision-making is itself a learning process. Choosing what to learn and the meaning of incoming information is seen through the lens of a shifting reality.
  • While there is a right answer now, it may be wrong tomorrow due to alterations in the information climate affecting the decision.
- Pender, N. (2011). The health promotion model manual. Retrieved from http://deepbluelib.umich.edu/bitstream/2027.42/85350/1/heal and http://www.nursing-theory.org/theories-and-models/pender-health-promotion-model.php Siemans G. (2005) Connectivism: A Learning Theory for the Digital Age, International Journal of Instructional Technology and Distance