Strategies for maintenance of health-promoting behaviors.

With our understanding of health expanding to include a dynamic of well-being, definitions of health vary, and activities associated with health promotion and disease prevention often overlap. Consequently, studies of health-promotion research include risk reduction. Most nursing studies are descriptive and cross-sectional, and although other disciplines report more intervention efforts, the same theoretic, definitional, and measurement issues exist in all studies. Women, older adults, and those better educated report a greater number of health-promoting behaviors and engage in a healthier lifestyle. An individual's view of health may affect his or her motivation to perform health-promoting behaviors. Removal of barriers, creation of supportive environments, and a strong sense of self-efficacy are important aspects of adoption and maintenance of health-promoting behaviors. Development of self-efficacy should be an integral part of health-promotion programs as increases in self-efficacy have been shown to precede the adoption and maintenance of health-promoting behaviors. Goal setting, contracting, and other behavioral techniques can help an individual develop competence in self-regulation of behavior. Outcomes of research must be congruent with the long-range view that promotion of health implies. Short-term outcomes may continue to be specific, but longer-term indicators will be more comprehensive. Measurement difficulties include evaluation of large-scale programs over extended periods, accounting for positive change in samples in which some persons already maintain health-promoting behaviors and proxy measures for future health. Future attention must be directed toward promoting healthy lifestyles and development of "wellness" thinking.