Health Promoting Lifestyle Profile II (HPLPII)

Abstract

The Health Promoting Lifestyle Profile II (HPLPII) is a widely utilized psychological instrument designed to measure the frequency of health-promoting behaviors across various domains of an individual’s life. Developed as an updated version of the original HPLP, the HPLPII consists of 52 items scored on a 4-point Likert scale. It assesses six core subscales: Spiritual Growth, Interpersonal Relations, Nutrition, Physical Activity, Health Responsibility, and Stress Management. The scale is grounded in the principles of health promotion theory and is essential for researchers and clinicians seeking to quantify lifestyle behaviors related to well-being and disease prevention.

Keywords

Health Promoting Lifestyle Profile II, HPLPII, Health behavior, Health promotion, Nursing research, Lifestyle assessment, Pender, Psychometric characteristics, Wellness.

Authors

Shirley N. Walker, Kay R. Sechrist, Nola J. Pender

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Purpose

The primary purpose of the HPLPII is to provide a comprehensive, multidimensional assessment of an individual’s self-reported engagement in health-promoting behaviors. It is intended for use in research settings, particularly within nursing and public health, to evaluate the effectiveness of health interventions and to identify specific behavioral patterns that contribute to or detract from overall health status.

The instrument provides both a total scale score, representing a global measure of a healthy lifestyle, and specific subscale scores, allowing practitioners to pinpoint areas where behavioral changes might be most necessary. This detailed output facilitates targeted health education and counseling based on the theoretical framework provided by the Health Promotion Model (HPM).

Construct

The HPLPII measures the construct of a Health-Promoting Lifestyle, which is defined as a pattern of self-initiated, self-directed cognitive-perceptual and behavioral activities aimed at maintaining or enhancing personal well-being, self-actualization, and health competence. The scale operationalizes this broad construct through six specific dimensions:

• Spiritual Growth: Belief in a purpose in life, internal harmony, and connection to a greater force.
• Interpersonal Relations: Maintaining meaningful relationships, expressing intimacy, and seeking support.
• Nutrition: Adopting a healthy diet based on recommended food guidelines (e.g., low fat, high fiber).
• Physical Activity: Engaging in regular exercise, including vigorous, moderate, and daily activity.
• Health Responsibility: Active participation in one’s own health care, seeking information, and monitoring symptoms.
• Stress Management: Utilizing effective coping mechanisms, relaxation, and balancing life demands.

Validity

Extensive research has been conducted to establish the validity of the HPLPII across diverse populations. Studies have demonstrated strong construct validity, supporting the theoretical delineation of the six subscales as distinct yet related components of a health-promoting lifestyle. Specifically, confirmatory and exploratory factor analysis (as cited in studies like Aubi et al., 2012, and Taheri Tanjani et al., 2016) generally supports the six-factor structure proposed by the developers, though slight variations may occur depending on the specific cultural context and population group tested.

Furthermore, criterion validity is supported by the HPLPII’s correlation with objective health outcomes and self-reported quality of life measures, confirming its utility as a predictive tool. The continued adoption and translation of the instrument into languages such as Persian also underscore its robust cross-cultural validation efforts.

Reliability

The HPLPII demonstrates high internal consistency, indicating strong reliability. Original development studies and subsequent international validation efforts consistently report high Cronbach’s alpha coefficients for the total scale, often ranging from 0.92 to 0.94, suggesting excellent reliability. Reliability coefficients for the individual subscales are typically acceptable, though they may vary slightly, generally falling between 0.70 and 0.90.

Studies focusing on specific adaptations, such as the Persian version (Mohammadi Zeidi et al., 2012; Taheri Tanjani et al., 2016), confirmed that the scale maintains its reliability characteristics when translated and applied to non-Western populations, reinforcing its global utility in health research.

Factor Analysis

The structure of the HPLPII was established through rigorous factor analysis, which confirmed the existence of six distinct, first-order factors corresponding to the six dimensions of the health-promoting lifestyle. This structure was an evolution from the original HPLP, which had fewer items and a slightly different factor configuration. The HPLPII’s 52 items load clearly onto the factors: Spiritual Growth, Interpersonal Relations, Nutrition, Physical Activity, Health Responsibility, and Stress Management.

This multidimensional structure is crucial as it allows researchers to investigate the complex interplay between different health behaviors, rather than treating health promotion as a unitary concept. While some cross-cultural studies have suggested minor modifications or potentially fewer factors (e.g., five factors in some Iranian samples), the six-factor model remains the most widely accepted representation of the HPLPII construct.

Instrument

Test Type: Self-report questionnaire / Psychological assessment scale

Format: 52 items, rated on a 4-point Likert scale (1=Never, 2=Sometimes, 3=Often, 4=Routinely). Higher scores indicate a more frequent engagement in health-promoting behaviors.

Language Available: English, Persian, and various other translations (e.g., Chinese, Spanish).

Population Group: General population, including adolescents, young adults, middle-aged adults, and the elderly.

Age Group: Adolescence through Older Adulthood (typically 18+ for research purposes, although adapted versions exist for younger groups).

Population Details: Originally developed using samples of adults in the United States, but extensively validated globally across diverse cultural and clinical groups.

Test Methodology: Summation of scores across all 52 items yields the total HPLPII score. Subscale scores are calculated by summing the items specific to each of the six dimensions.

Keywords

Spiritual growth, Interpersonal relations, Nutrition assessment, Physical activity measure, Health responsibility, Stress management scale, Pender’s Model, Behavioral intervention.

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Authors

Author ORCID Identifier: N/A (Information not provided in source)

Affiliation Email addresses: N/A (Information not provided in source)

Correspondence Address: N/A (Information not provided in source)

Permissions & Fee and Test Year

The original Health-Promoting Lifestyle Profile (HPLP) was developed in 1987 by Walker, Sechrist, and Pender. The revised version, HPLPII, was formalized and extensively used in subsequent years, notably detailed in Pender’s 1996 text. The scale is generally available for non-commercial academic and clinical use, though formal permission may be required from the authors or their affiliated institutions for large-scale use or commercial application.

The scale instrument and scoring information are often made available freely for research purposes. The original PDF for the HPLPII can be downloaded here: https://www.brandeis.edu/roybal/docs/Health-Promoting%20Lifestyle%20Profile%20II%20_website_PDF.pdf.

Reference’s

• Walker, S.N., Sechrist, K.R., & Pender, N.J. et al.(1987). The Health-Promoting Lifestyle Profile: Development and Psychometric characteristics. Nursing Research, 36, 76-81.
• Walker, S.N., Volkan, K., Sechrist, K.R., & Pender, N.J. (1988). Health-promoting life styles of older adults: comparisons with young and middle-aged adults, correlates and patterns. Advanced Nursing Science. 11. (1)76-90.
• Pender, N J. (1996). Health promotion in nursing practice. Stamford, Conn. Appleton & Lange. P. 18-28.
• Mohamadian, H., Eftekhar, H., Rahimi, A., et al. (2011). Predicting health-related quality of life by using a health promotion model among Iranian adolescent girls: A structural equation modeling approach. Nurs Health Sci,13,141–8.
• Aubi, E., Shadnoush, M., Nazarzadeh, M., Bidel, Z., Ranaei, A., Delpisheh A. (2012).Translation and assessment of validity and reliability of the health-promoting lifestyle questionnaire, using factor analysis. Pejouhandeh, 17(3),114-120.
• Mohammadi Zeidi, I., Pakpour, A.H, Zeidi, B.M. (2012). Reliability and validity of Persian version of the health-promoting lifestyle profile. J Mazandaran Univ Med Sci,21:102–13.
• Taheri Tanjani, P., Azadbakht, M., Garmaroudi, G., Sahaf, R., Fekrizadeh, Z. (2016). Validity and Reliability of Health Promoting Lifestyle Profile II in the Iranian Elderly. International Journal of Preventive Medicine. 2016; 7: 74.

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Items of the Health Promoting Lifestyle Profile II (HPLPII)

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way.

1. Discuss my problems and concerns with people close to me.
2. Choose a diet low in fat, saturated fat and cholesterol.
3. Report any unusual signs or symptoms to a physician or other health professional.
4. Follow a planned exercise program.
5. Get enough sleep.
6. Feel I am growing and changing in positive ways.
7. Praise other people easily for their achievements.
8. Limit use of sugars and food containing sugar (sweets).
9. Read or watch TV programs about improving health.
10. Exercise vigorously for 20 or more minutes at least three times a week (such as brisk walking bicycling aerobic dancing using a stair climber).
11. Take some time for relaxation each day.
12. Believe that my life has purpose.
13. Maintain meaningful and fulfilling relationships with others.
14. Eat 6-11 servings of bread, cereal, rice and pasta each day.
15. Question health professionals in order to understand their instructions.
16. Take part in light to moderate physical activity (such as sustained walking 30-40 minutes 5 or more times a week).
17. Accept those things in my life which I cannot change.
18. Look forward to the future.
19. Spend time with close friends.
20. Eat 2-4 servings of fruit each day.
21. Get a second opinion when I question my health care provider’s advice.
22. Take part in leisure-time (recreational) physical activities (such as swimming, dancing, bicycling).
23. Concentrate on pleasant thoughts at bedtime.
24. Feel content and at peace with myself.
25. Find it easy to show concern, love and warmth to others.
26. Eat 3-5 servings of vegetables each day.
27. Discuss my health concerns with health professionals.
28. Do stretching exercises at least 3 times per week.
29. Use specific methods to control my stress.
30. Work toward long-term goals in my life.
31. Touch and am touched by people I care about.
32. Eat 2-3 servings of milk, yogurt or cheese each day.
33. Inspect my body at least monthly for physical changes/danger signs.
34. Get exercise during usual daily activities (such as walking during lunch, using stairs instead of elevators, parking car away from destination and walking.)
35. Balance time between work and play.
36. Find each day interesting and challenging.
37. Find ways to meet my needs for intimacy.
38. Eat only 2-3 servings from the meat, poultry, fish, dried beans, eggs, and nuts group each day.
39. Ask for information from health professionals about how to take good care of myself.
40. Check my pulse rate when exercising.
41. Practice relaxation or meditation for 15-20 minutes daily.
42. Am aware of what is important to me in life.
43. Get support from a network of caring people.
44. Read labels to identify nutrients, fats, and sodium content in packaged food.
45. Attend educational programs on personal health care.
46. Reach my target heart rate when exercising.
47. Pace myself to prevent tiredness.
48. Feel connected with some force greater than myself.
49. Settle conflicts with others through discussion and compromise.
50. Eat breakfast.
51. Seek guidance or counseling when necessary.
52. Expose myself to new experiences and challenges.