r behavior; interact with the environment, transforming it and being transformed as well; and are influenced by health professionals as part of the interpersonal environment. The HPM model also assumes that self-initiated reconfiguration of the person-environment interactive patterns is required before behavior change (Pender, Murdaugh, & Parsons, 2002).
Theoretical propositions of the HPM include: inherited and acquired characteristics and prior behavior influence beliefs, affect, and enactment of health-promoting behaviors; people commit to new behaviors when they anticipate personally valued benefits; perceived barriers may constrain action and behavior commitment; perceived competence and self-efficacy to execute a behavior leads to increased commitment to action and actual behavioral performance; increased self-efficacy leads to fewer perceived barriers to a health behavior; positive affect toward behaviors leads to increased perceived self-efficacy and in turn increased positive affect; positive emotions or affect associated with behaviors leads to increased commitment and action; increased commitment and engagement in health-promoting behaviors is modified by behavior modeling by significant others, expectation that the behavior will occur, and provisions of assistance and support to enable the behavior; sources of interpersonal influence include families, peers, and health care providers, which increase or decrease commitment to and engagement in behaviors; external environmental or situational influences can increase or decrease commitment to or participation in behaviors; increased commitment to an action plan leads to increased maintenance of health-promoting behaviors over time; commitments for action plans may not result in desired behaviors if competing demands, which cannot be controlled, require immediate attention; commitment to an action plan may not result in the desired behavior if other actions appear to be mo...