The relationships among social support, spiritual well-being, commitment and health-promoting behaviors in older adults

Study purpose was to examine relationships among personal factors, social support, spiritual well-being, commitment and health-promoting behaviors in three elderly age groups. Pender's revised Health Promotion Model (HPM) guided development of a theoretical model for this correlational study. Criteria for inclusion were (a) self-caring, (b) community dwellers, (c) English speaking, (d) adults aged 65 and older who were (e) without known cognitive impairment. The sample of 595 seniors was divided into three age groups: 65--74, 75--84, and 85+. Data collection sites included senior centers and residences, social/civic groups and religious congregations in communities of four geographic areas.; For data collection, a demographic form and four self-report scaled questionnaires were used: the Physical Activity, Nutrition, Stress Management, and Health Responsibility Subscales of the Health-Promoting Lifestyle Profile II; the Commitment Subscale of the Health-Related Hardiness Scale; the Personal Resource Questionnaire 85, Part 2; and the JAREL Spiritual Well-Being Scale. Statistical analyses conducted using SPSS-PC included measures of central tendency, Pearson correlation, analysis of variance, Scheffe' tests and Levene Tests for Homogeneity of Variance. Structural equation modeling with Amos software was conducted. Cronbach's Alpha coefficients provided reliability measures for instruments.; Findings supported relationships hypothesized by Pender's HPM and that older adults are not a homogeneous group. Age group differences were in levels of commitment and physical activity. The theoretical model was supported in each age group, with an interaction effect between Social Support (SS) and Spiritual Well-Being (SWB) and each concept having direct and indirect effects on Commitment. A surprising and new finding was that SS and SWB only indirectly influenced HPB through Commitment. Influence of Commitment on HPB was significant in age groups I and II, but not in age group III. A Personal Factors concept was not supported. Individual personal factors had direct and indirect effects on specific health-promoting behaviors in all age groups, suggesting that specific personal factors are more relevant to performance of one behavior than to another. Findings suggest that commitment to healthy behaviors may no longer be an important issue for those age 85+. Health-Promoting Behaviors is important conceptually, but not as a latent concept in studying older adult healthy behaviors. Implications were primarily for the efficacy of the Health Promotion Model for planning, providing and evaluating health promotion programs for older adults. Further investigation among elders is warranted.