Promoting Health Promotion Practices in the Low Income Population

The increasing proportion of the low income, uninsured population has become the focus of the United States health care reform.  The importance of health promotion is emphasized in the literature and the Affordable Care Act.  The literature has focused on perceived health status, perceived health competence and health-promoting behaviors of some populations but revealed that little is known about the health promotion behaviors of the low income population.  In 2013, an exploratory, descriptive study using a structured interview method was used to explore the perceived health status, perceived health competence and health-promoting behaviors of this population with a sample of 44 uninsured adults, whose income was at 200% of federal poverty or lower, and who spoke and understood English.  Using Pender’s Health Promotion Model as a framework, the pilot project also explored the relationships among the variables.  A questionnaire consisting of four questions exploring health status, the Perceived Health Competence Scale (PHCS), the Health-Promoting Lifestyle Profile II (HPLP II) and a demographic survey was used during a face-to-face structured interview with each informant once a written consent had been obtained.  Data from 41 questionnaires were analyzed using descriptive statistics, two-tailed t-tests, ANOVA and Pearson correlation statistics.  The results indicated that the informants rated their health as good to fair, reported a moderate degree of health competence, and engaged primarily in interpersonal relations and spiritual growth behaviors. The project contributed to the understanding the low income population’s perceptions of their health, their health competence and health promotion behaviors, and provided a direction for future research and clinical care.  The results from this study have guided the beginning of the transformation of clinical practice at a non-profit health clinic in Denton, Texas.  The change strategies included team meetings and refocusing on the mission of the clinic.  The challenges were varies and will be described in the presentation.  The outcomes of the adoption of a new care delivery model that focused on fostering health promotion behaviors include increased adherence to treatment plans, decreased rate of not showing up for appointments, and patient satisfaction.