A causal model based on Pender's (1987) Health Promotion Model was tested to evaluate Pender's hypothesis that demographic and biological characteristics affect health-promoting behaviors indirectly through three mediating cognitive-perceptual variables. A sample of 3,025 noninstitutionalized adults completed a telephone survey from which indicators of the conceptual variables were selected. Initial tests of the causal model using the LISREL 7 program indicated that the basic model did not fit the data. Therefore, the model was modified so that the exogenous variables--sex, age, income, martial status, education, and body mass index--had direct effects on select health-promoting behaviors. Further, the variables of self-actualization and interpersonal support were required to share common indicators as were health responsibility and interpersonal support. Though the modified model fit the data, little of the variance in health-promoting behaviors was explained, since all significant effects were weak.
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Johnson et al. (1993) studied this question.