Causal relationship model of process of change and health promotion behavior among elderly at risks with ischemic heart disease


  • Nawarat Suthipong Central Chest Institute of Thailand
  • Ungsinun Intarakamhang Behavioral Science Research Institute, Srinakharinwirot University
  • Narisara Peungposop Behavioral Science Research Institute, Srinakharinwirot University


process of change, social support, health promotion behavior, elderly at risks with ischemic heart disease, structured equation modeling


           The purpose of this study was to empirically validate the causal relationship model of process of change and health promotion behavior among elderly at risks with ischemic heart disease. The samples were 690 person; aged 60 to 69 years who living in Nonthaburi Municipality and Pakkret Municipality, Nonthaburi Province. The samples method were stratified random sampling. The questionnaires were used to collect data: cognition influencing; trust; social support; process of change; and health promotion behavior. The data were analyzed using the structured equation modeling technique.

           The result showed that the relationship structure of process of change and health promotion behavior with empirical data (gif.latex?\chi2= 454.41, df = 189, p< 0.001, gif.latex?\chi2/df = 2.40, RMSEA = 0.046, SRMR = 0.040, CFI = 0.99,    GFI = 0.94, AGFI = 0.92). The result of path analysis showed that: The process of change and social support had direct effect on health promotion behavior (β = 0.40, 0.28, p< 0.05). The process of change a mediating role variable of the indirect effect between cognitions influences and health promotion behavior (β = 0.35, p< 0.05), and The cognitions influences and process of change a mediating role variable of the indirect effect between trust and health promotion behavior (β = 0.15, p< 0.05). All of the above mentioned causal variables together explain the variance of 59% of the health promotion behavior variable.

            This study suggested that health care provider involved in the health of the elderly at risks with Ischemic Heart Disease. Apply the process of change and social support to apply as a health promotion guideline for the elderly to prevent ischemic heart disease.


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