Psychosocial Environment: A Health Promotion Model

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Abstract
This article presents a multidimensional model of psychosocial determinants of health behavior for health promotion research and policy analysis. Frequently, health promotion focuses almost exclusively on intrapsychic determinants and on individual level behavior. Based upon Field Theory and attitude theories, this proposed model holds that in populations with comparable sociodemographic and biological status (exogenous variables) a health behavior is a function of direct and interaction effects of five key intrapsychic and external variables. These are: behavioral intentions, social support, accessibility of means for action, personal autonomy, and action situation. Empirical tests with cross-cultural studies in Venezuela, Kenya, and the Philippines provide substantial support for the model. The findings suggest that while health promotion strategies should deal with intrapsychic determinants of behavior, key extrapsychic factors (such as social support, quality and accessibility of health care measures, and situational factors) all have direct and independent effects on health behavior as well. Health promotion research and interventions which aim exclusively at intrapsychic determinants would thus have rather limited overall value. The article discusses key research and policy implications of the model presented.