Title: The health belief model
Course: Level 3 - Health Education and Promotion > Section: Behaviour change models

The health belief model is one of the earliest and best-known health behavior models developed in the 1950's by social psychologists Hochbaum, Rosenstock and others, who were working in the U.S. Public Health Service to explain the failure of people participating in programs to prevent and detect disease. Later, the model was extended by others to study people's behavioral responses to health-related conditions. Since this time, the Health Belief Model has evolved to address public health concerns and has been applied to a broad range of populations and health behaviors.

Two major factors influence the likelihood that a person will adopt a recommended preventive health action. First, they must feel personally threatened by disease i.e. they must feel personally susceptible to a disease with serious or severe consequences. Second, they must believe the benefits of taking the preventive action outweigh the perceived barriers of (and/or cost of) preventive action.

The health belief model assumes that the most important determinants of people's behaviors are their beliefs or perceptions. There are four major concepts/constructs related to perceptions and beliefs and the model is used to plan and give individual health education.

Constructs of the Health Believe Model

A. The perceived susceptibility --- one's perception of chances of getting the condition or a disease.
B. The perceived severity --- one's perception of how serious the condition/disease and its consequences.
C. The perceived benefit --- one's opinion of the efficacy of the advised action to reduce the risk or seriousness of the condition/disease
D. The perceived barriers --- one's opinion of the tangible and psychological costs of the advised action or behavior
E. Cues to action --- strategies to activate readiness of the individual/community for the advised action/behavior
F. Self-efficacy --- confidence on one's ability to take action.

Applications of the Health Belief Model

During the application process of the model you need to do the following:

- Define the population at risk based on a person's features or behavior -- perceived susceptibility
- Specify consequences of risk and condition --- perceived severity
- Define action to take, how, where, when clarify the positive effects to be expected -- perceived benefit
- Identify and reduce barriers through reassurance, incentives, assistance --- perceived barriers
- Provide how to inform action, promote awareness, reminders (through mass media) --- cues to action
- Provide training, or guidance in performing action --- -self-efficacy

Examples

Example 1: Application of the model for HIV/AIDs --- a young man wants to use a condom (action/behavior).

Figure 11.1. Health belief model applied for an HIV/AIDs program.

- A young man has been engaging in sex with multiple partners (perceived susceptibility).
- A young man beliefs that AIDS a death sentence since there is no cure (perceived severity).
- A young man believes that he is at risk because; his friend is ill (perceived threat).
- A young man wants to hear a radio messages explaining the need for safe sex, peer education and so on (cues to action).
- A young man thinks that condoms are easy to use, and with condoms, one can feel safer sexual intercourse (perceived benefit), however, condoms are not readily available, and they are costly (perceived barriers).
- A young man has developed self-confidence to buy and use condoms (perceived self-efficacy).
- A young man buys and uses condoms regularly (desired behavior/action).

Example 2: A 42 years old woman is interested to get a mammography to understand about breast cancer

  - She perceived that she has a high chance of getting breast cancer (perceived susceptibility).
  - She perceived that her marriage would be endangered if she had breast cancer (perceived severity).
  - She perceived that getting a mammogram will bring her peace of mind (perceived benefit).
  - She perceived that getting a mammogram is embarrassing (perceived barrier).
  - She perceived that hearing about breast cancer in the news makes her think about getting a mammogram (cues to action).
  - She perceived that she is sure and confident to get the breast cancer screening/mammography (self-efficacy).
  - She has get mammography and also thinks to get it again in the future.