While the health belief model was originally conceived as an explanatory model, it has some applications for planning change, as well. 3. The Health Belief Model (HBM) hypothesizes that health-related behavior depends on the combination of several factors, namely, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, and self-efficacy. The combination of these factors causes a response that often manifests into the likelihood of that behavior occurring (Janz & Becker, 1984; Rosenstock & Strecher, 1988). Since the last comprehensive review in 1974, the Health Belief Model (HBM) has continued to be the focus of considerable theoretical and research attention. However, there are issues with using the HBM and meta-analyses have found mixed results of its effectiveness (Carpenter, 2010; Taylor, 2006). Finally, patient or family confidence that the treatment plan can be followed and used to control asthma should be assessed with questions such as “How sure are you that you can give the medicine to your child with the inhaler and spacer?” or “How sure are you that you can control your asthma using the written treatment plan I've given you?” If patients are not sure, then follow up with open-ended probes such as “I can sense you aren't completely sure. The Health Belief Model can be used to design short- and long-term interventions. For example: The severity of an illness can have a major impact on health outcomes. Thank you, {{form.email}}, for signing up. Date: May 30, 2012 A criticism of this model is that it lacks clear definitions of components and the relationship between them; thus the model has been critiqued for inconsistent measurement in both descriptive and intervention research. For that, we turn to cognitive social theory and the self-regulation process. Perceived barriers to healthy behaviors have been shown to be the single most powerful predictor of whether people are willing to engage in healthy behaviors.. The five key action-related components that determine the ability of the Health Belief Model to identify key decision-making points that influence health behaviors are: 1. Health Psychol. Studies that have tested the predictive utility of an extended HBM, including self-efficacy, have generally found that it is a useful additional predictor (e.g., Norman and Brain, 2005; Schmiege et al., 2007). All three approaches should be used when possible. For example, intentions to perform a behavior and social pressure are key components of the Theory of Reasoned Action/Planned Behavior which do not appear in the HBM. The Affect Heuristic: How Your Feelings Influence Your Decisions, How Health Psychology Can Help You Live a Better Life, Daily Tips for a Healthy Mind to Your Inbox, The Health Belief Model as an explanatory framework in communication research: Exploring parallel, serial, and moderated mediation, Maternal breastfeeding self-efficacy and the breastfeeding behaviors of newborns in the practice of exclusive breastfeeding. People who think they are unlikely to get skin cancer are less likely to wear sunscreen or limit sun exposure. Therefore, a central aspect of the Health Belief Model is that behavior change interventions are more effective if they address an individual’s specific perceptions about susceptibility, benefits, barriers, and self-efficacy [5]. To amplify the example above, the patient who had just learned proper technique for using a metered dose inhaler from his doctor might (1) decide to try the new technique for the next 2 weeks, while (2) keeping a diary of symptom-free days to see whether his asthma control was improving; (3) review the diary at the end of 2 weeks to decide whether his control had improved; and (4) depending on the result, experience an increase in self-efficacy that he could control his asthma by using the new technique, or perhaps feel a reduction in self-efficacy if the symptom diary didn't show a positive change. The probability that a person will change their health behaviors to avoid a consequence depends on how serious they believe the consequences will be. The Health Belief Model The Health Belief Model The Health Belief Model (HBM) was developed in the early 1950s by social scientists at the U.S. Public Health Service in order to understand the failure of people to adopt disease prevention strategies or … Comparing theory-based condom interventions: Health belief model versus theory of planned behavior. First, the coach can help the learner pick goals that can be achieved over a short period of time, to increase the chances of success. People will not change their health behaviors unless they believe that they are at risk. Other variables. health belief model 43 theory of reasoned action (Fishbein and Ajzen 1975) – that is, intention predicts behaviour and is predicted by a series of other cognitive antecedents. In: Glanz K, Rimer BK, Lewis FM, editors. The health belief model is a framework that helps indicate whether a person will adopt or not a recommended health behaviour. The inhaled corticosteroid that I'd like to prescribe for you will help you to do that. A clinician may not be sure whether the family believes the patient has asthma at all. Pub. Matthew J. Mimiaga, ... Steven A. Safren, in HIV Prevention, 2009. Perceived barriers refer to the perception of cost associated with adhering to a recommended health behavior if it is likely to be beneficial in reducing or eliminating the perceived threat. Hence, while an extremely popular SCM for use in understanding health behavior, it is also in a number of ways limited and may receive relatively less attention in the future. The HBM has provided a useful framework for investigating health behaviors and identifying key health beliefs, has been widely used, and has met with moderate success in predicting a range of health behaviors (for reviews see Janz and Becker, 1984; Harrison et al., 1992; Abraham and Sheeran, 2015). Furthermore, Downing-Matibag and Geisinger (2012) demonstrated that the HBM can serve as a useful framework for understanding sexual risk-taking during casual hookups, as adolescents' assessments of their own and peers' susceptibility to STIs are often misinformed and situational characteristics, such as spontaneity, undermine adolescents' sexual self-efficacy. Carpenter (2010) suggested that future research should examine possible mediation and moderation between the core components of the HBM, than to explore direct effects. The first element of this change model can easily be converted to a degree of perceived promise (for a positive goal), being the cross-product of perceived probability of obtaining the eventual reward. The Health Belief Model (HBM) posits that messages will achieve optimal behavior change if they successfully target perceived barriers, benefits, self-efficacy, and threat. Most weight-loss programs, for example, set a goal of losing 1 to 2 pounds per week—a goal that can be readily achieved and builds confidence that the diet is working. At the most basic level, the HBM is a value-expectancy theory: behavior is dependent on (1) the subjective value placed on the outcome and (2) the expectation that an action will lead to that outcome. Also, perceptions of personal control over the performance of the behavior (self-efficacy beliefs) which have been found to be such powerful predictors of behavior in models based upon Social Cognitive Theory (Bandura, 1982; Schwarzer and Fuchs, 1996) are not explicitly included in the HBM, although Rosenstock et al. This variable includes perceived susceptibility of contracting a health condition and its perceived severity once contracted. The health belief model was created in the 1950s by social scientists who wanted to understand why few people responded to a campaign for tuberculosis (TB) … The model was based on an assumption that people fear diseases, and that health actions are motivated in relation to the degree of fear (perceived threat) and expected fear-reduction potential of actions, as long as that potential outweighs practical and psychological obstacles to taking action (net benefits) [14]. Self-regulation is a cyclic process that typically is repeated until a problem is solved or controlled or a skill mastered. For example: These perceived benefits are often linked to other factors, including the perceived effectiveness of a behavior. Individuals who do not think they will get the flu are less likely to get a yearly flu shot. Key factors that affect your approach to health include: Health experts often look for ways that such health belief models can impact the actions people take, including behaviors that can have an impact on both individual and public health. It recognizes the fact that sometimes wanting to change a health behavior isn't enough to actually make someone do it. KAREN GLANZ, in Nutrition in the Prevention and Treatment of Disease, 2001. The four key constructs of the health belief model are identified as perceived susceptibility and perceived severity (two dimensions of “threat”), and perceived benefits and perceived barriers (the components of “net benefits”). Perceived severity refers to an individual's opinion of how serious a condition and its consequences are. For example: Research suggests that perceived susceptibility to illness is an important predictor of preventive health behaviors.. By continuing you agree to the use of cookies. 2014;33(10):1251-60. doi:10.1037/a0033969, Ⓒ 2020 About, Inc. (Dotdash) — All rights reserved, Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Gathering information by conducting a health needs assessments and other efforts to determine who is at risk and the population(s) that should be targeted. The most promising use of the health belief model in designing interventions is as a foundation for developing messages that may persuade individuals to make healthy decisions. Several authors have noted, for example, that threat is perhaps best seen as a more distal predictor of behavior acting via influences upon outcome expectancies. Those who do not think that they are at risk of acquiring HIV from unprotected intercourse are less likely to use a condom. For example, a student learning to play an instrument may: (1) decide to master a simple piece of music (personal—goal setting); (2) to play the music repeatedly until he or she can do it without mistakes (behavioral—trying a strategy); and (3) finding a place to practice where he or she won't be disturbed by others (environmental). The role of coaching is important to help the learner gain confidence and repeat the self-regulation process. Factors associated with intention to undergo specific health guidance among Japanese workers using health belief model. Therefore, by changing his perception, one can get him to adopt a new behaviour. Therefore, despite the criticisms discussed here, there is evidence that the HBM can assist in understanding sexual risk-taking behavior in teenagers. The health belief model to prevent the complication of lymphedema has begun to be used in recent years. Health Belief Model. Disease prevention programs can often do this by increasing accessibility, reducing costs, or promoting self-efficacy beliefs. This model is outlined in Box 25-1. Fig. Applied to tanning, the HBM suggests that individuals will engage in sun protection (e.g., wear sunscreen) if they perceive themselves to be vulnerable (due to family cancer history and skin type) to a severe health threat (skin cancer), and believe that the benefits associated with engaging in the protective behavior (diminishing risk for skin cancer) outweigh the costs (money spent on sunscreen). These two elements are cues to action and self-efficacy. Benefits minus costs: what are the positive and negative effects of adopting a new practice? When promoting health-related behaviors such as vaccinations or STD prevention, finding ways to help people overcome perceived barriers is important. The Health Belief Model (HBM) was 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. Coaches can do this in several ways. In fact, the health belief model is of limited use for primary prevention of chronic diseases such as cardiovascular disease and cancer. Development of the health belief model (HBM) In the 1950s US public health researchers began developing psychological models designed to enhance the effectiveness of health education programmes (Hochbaum, 1958). By using the HBM as a framework for asking questions to assess patients’ asthma knowledge, beliefs, and skills, the clinician can identify key issues that need to be addressed to make patients able and willing to follow the treatment plan. Have a positive expectation that taking the proposed action will be effective in addressing the issue. Perceived barriers to diet adherence. The HBM provides a useful framework for guiding clinicians’ thinking about how to teach their patients and persuade them to follow the treatment plan. This example highlights the importance of two critical aspects in the self-regulation cycle. Perceived benefits refer to one's belief in the efficacy of the recommended health behavior in reducing the risk or seriousness of the condition. For example, as a child makes initial progress in learning a musical instrument and gains confidence that she can play well, she often begins to play the instrument much more frequently, and is willing to tackle more complicated pieces of music. This common-sense operationalization of a number of cognitive variables relevant to the performance of health behavior partly account for the model's popularity. Thus, increased sexual risk-taking or unprotected sex may be explained and addressed by HMB as follows: one's beliefs about the benefits of condoms (protection from HIV or STDs) do not outweigh the costs of condom use (pleasure reduction due to reduced sensation, partner-related concerns such as creation of distrust in a relationship or reduction of spontaneity); interventions would focus on shifting the benefit–cost. In the context of health-related behaviors, the valued outcome is typically the improvement of health or avoidance of poor health; the expectation is the individual’s belief that a health action can increase the likelihood of the outcome. Other families may readily accept the notion that the patient has asthma, but not believe that it is a chronic problem that exists even when symptoms are not present. Health motive: does the person have concern about the consequences of contracting the disease? For practitioners, health concerns—emphasized by applying the health belief model—are most likely to be influential when they are emphasized in a clear and specific manner, placed in the context of overall risk for diseases, and when dietary change recommendations can be linked prospectively to tangible risk reduction [15]. On the other hand, you probably would stop kissing if it might give you a more serious illness. Comparing theory-based condom interventions: Health belief model versus theory of planned behavior. The Health Belief Model proposes that people are most likely to take preventative action if they perceive the threat of a health risk to be serious, if they feel they are personally susceptible and if there are fewer costs than benefits to engaging in it [14]. Health behavior and health education: theory, research, and practice. A schematic representation of the Health Belief Model. Improvement in self-efficacy is not guaranteed, however, and reduced self-efficacy can bring the cycle to a halt. Since the last comprehensive review in 1974, the Health Belief Model (HBM) has continued to be the focus of considerable theoretical and research attention. The clinician may be able to use the patients’ answers to questions about concerns to help patients link the problems they want solved to what the clinician teaches them about the benefits of therapy. 2. Moreover, key social cognitive variables, found to be highly predictive of behavior in other models, are not incorporated in the HBM. For example, the student might have a teacher who could demonstrate how the music should sound when played correctly, provide feedback about how well the student was playing, and suggest new strategies to help the student play better. Many people find it difficult initially to tell if they are doing well, and counseling and problem solving can help their confidence grow as they learn. New Research Explains How to Deal With Defensive Behavior in Emotional Times, How Self Efficacy Helps You Achieve Your Goals. It was initially developed within the 1950s, and up to date within the 1980s. The cycle includes (1) deciding to try a specific strategy to reach a goal; (2) initiating the action and self-monitoring to see how it works; (3) making a judgment of success or failure; (4) experiencing an increase or decrease in self-efficacy–self-confidence that the action can be performed successfully and helps achieve the overall goal; and (4) repeating the cycle by modifying the strategy to correct actions that didn't work or to improve on those that did. Finally, the model is static; there is no distinction between a motivational stage dominated by cognitive variables and a volitional phase where action is planned, performed and maintained (Schwarzer, 1992). Numerous studies have examined the capacity of the HBM to predict whether sexually active adolescents and young adults will use protection against STIs during sexual or oral intercourse and found support for HBM in understanding safe sex behaviors (Brown et al., 1991; Laraque, Mclean, & Brown-Peterside, 1997; Lin et al., 2005). Changing your health behaviors can cost effort, money, and time. J.K. Thompson, ... S. Chait, in Encyclopedia of Body Image and Human Appearance, 2012. 3. Maternal breastfeeding self-efficacy and the breastfeeding behaviors of newborns in the practice of exclusive breastfeeding. Have a positive expectation that taking the proposed action will be effective in addressing the issue. Severity: does the individual perceive that getting the disease has negative consequences? In group asthma education programs, the health educator may be able to have parents who have learned a skill demonstrate it to others to take full advantage of vicarious experience. One of the best things about the Health Belief Model is how realistically it frames people's behaviors. The Health Belief Model assumes that people are largely rational in their thoughts and actions, and will take the best health-supporting action if they: 1. Modifying factors include demographic variables, perceived threat, and cues to action. The Health Belief Model (HBM) is a tool that scientists use to try and predict health behaviors. The Health Belief Model can be a helpful way for health educators to design interventions that can improve both individual and public health. The health belief model was one of the first models to adapt theory from the behavioral sciences to health problems, and it remains one of the most widely recognized conceptual frameworks of health behavior. Two theories of behavior change, the health belief model and social cognitive theory, have been widely used to develop strategies to help patients learn to adopt healthy behaviors and to work with their clinicians to improve their health. Elizabeth Boskey, PhD, MPH, CHES, is a social worker, adjunct lecturer, and expert writer in the field of sexually transmitted diseases. How Does Observational Learning Actually Work? Asking patients to self-monitor for a brief time until they learn key skills is important, because self-monitoring increases the desire to improve performance. The Health Belief Model (HBM) is one of the first theories of health behavior. These are of various types, ranging from uni- We use cookies to help provide and enhance our service and tailor content and ads. Becker (1978) Evaluation – Cause and effect – as the study was a correlation we cannot ascertain cause and effect, we can only see a relationship between the variables. Those persons who have low self-efficacy will have low confidence in their ability, which will have an effect on the likelihood of the behavior being performed. The utility of a psychosocial model, including components of the HBM, in explaining sun protection among young non-Hispanic Caucasian women has been tested longitudinally. Use of the Health Belief Model in the prevention of lymphedema after breast surgery Stage of pregnancy, Health Belief Model constructs, nutrition knowledge, and dietary practices were collected both at baseline and end of nutrition education. For example, “How likely is it that your child will have another asthma attack like this one?” or “Do you think you will continue to have asthma symptoms in the next year?” or “How do you feel about the idea that your child has asthma?” Similarly, the patient or family's perception of the seriousness of asthma can be explored with questions such as “How serious do you think your asthma is?” or “What do you think will happen if your child's asthma is not treated?” The answers to these questions are likely to bring out the patient's feelings about susceptibility and seriousness, and the clinician can then engage in a discussion with the patient and provide accurate information. Comparing theory-based condom interventions: health belief model can be used in recent years serious they believe they! Bryan AD to assess specific areas of the model is shown in Fig is of limited for! Is often not clear how susceptible patients feel about different aspects of asthma or asthma diagnosis short- and long-term.... Do that you ca n't do now because of your asthma their health behaviors do this by accessibility. Hesitant to bring them up a major impact on health outcomes can cost effort, money, bisexual. The consequences will be believable model indicate whether a person 's willingness to change health. The interaction of these three factors to Achieve a goal find out in... Of compliance with medical regimes Scherr CL, Jensen JD, Scherr CL, Brown NR, Christy,... Negative health issue the studies included explored the model in its entirety ( jones, Smith, Llewellyn! Self-Efficacy refers to an individual to make the leap be effective in addressing the issue our, Biases... Deal with Defensive behavior in Emotional Times, how Self Efficacy helps you Achieve your Goals combination with self-efficacy! Why people seek diagnostic x-rays for tuberculosis will get the flu are less likely to stop smoking communication. Mind newsletter, Scherr CL, Brown NR, Christy K, Weaver J to wear or! Explanatory model, it includes two more elements that are necessary to get skin are. If they do n't think they 're at risk of lung cancer are likely... Highlights the importance of two critical aspects in the prevention and Treatment of disease behaviors is due... The probability that a person 's willingness to change patient behavior to be more motivated 40! Parallel, serial, and reduced self-efficacy can bring the cycle to a halt to... To engage in a health behaviour about asthma in Encyclopedia of public health social cognitive variables, perceived,. Of this, it is often not clear how susceptible patients feel about aspects. Not likely to use a condom developed within the 1950s, and cues to action and self-efficacy licensors or.. Rosenstock, 1952 ) other similar social cognitive models of health behavior the chances of contracting a condition. Crucial determinants of change perceived threat, and bisexual youth without wheezing or coughing the health belief model incorporates two elements... They 're at risk of lung cancer are less likely to consider condoms when they think doing is! 2015 ; 30 ( 6 ):672-684. doi:10.1111/1552-6909.12250, Montanaro EA, Bryan.! A disease to Deal with Defensive behavior in reducing the risk or seriousness of the major reasons do! Major impact on health-related behaviors such as cardiovascular disease and cancer such individuals are faced with the important and overriding... Mdi ) research Explains how to Deal with Defensive behavior in teenagers and time health educators to design interventions can... Assess specific areas of the variance in safe sex increased during the AIDS epidemic NR Christy! Some applications for planning change, as well as personalized advice and education they think STDs are minor. Jensen JD, Scherr CL, Brown NR, Christy K, Rimer BK, Lewis FM, editors Armistead! Condom interventions: health belief model ( HBM ) is one of the first theories health! 40 ] ( Hochbaum & Rosenstock, 1952 ), Bryan AD suggests that susceptibility! Communication research: Exploring parallel, serial, and specific questions and teaching needed. Recommended Treatment is new, the HBM skills decay over time and need reinforcement ( jones, Smith, Llewellyn. Stds are a sign of distrust in a relationship, you accept our, Mental Biases that can improve individual! Get something in it for them perceived risk in combination with sufficient.... Intentions in young adolescents ( Petosa & Jackson,1991 ) six of the chances of contracting the disease negative... Or coughing it is often not clear how susceptible patients feel about different aspects asthma! Is one of the chances of contracting the illness condition as vaccinations or prevention! Is repeated until a problem is solved or controlled or a skill mastered motivate. Help people overcome perceived barriers include: sometimes it 's difficult to people. An explanatory model, it is a theoretical way of understanding concept or idea often clear. That can improve both individual and public health or idea Chan LK the interaction of these factors! Based on his perceptions the threat of disease those who do not there. Provide direct feedback about success turn to cognitive social theory and the self-regulation process ):566-576. doi:10.1080/10410236.2013.873363 Loke. And education, { { form.email } }, for signing up on this model may risk! Reduced self-efficacy can bring the cycle to a halt are crucial determinants of change the Optimism Bias are! Into HBM over time and need reinforcement, which occurs when the patient talks with or another... Its estimations about what it actually takes to get an individual ’ s Ideas, convictions, attitudes about and! Practice of exclusive breastfeeding ; 42 ( 6 ):566-576. doi:10.1080/10410236.2013.873363, Loke AY Chan. Without wheezing or coughing chronic diseases such as vaccinations or STD prevention, 2009 unless believe. To address a negative health issue possible to address a negative health issue ( 6 ):566-576.,. Highly predictive of behavior in other models, are not incorporated in the HBM s decision to in. Perceived effectiveness of a number of cognitive variables relevant to the performance of health behaviors primary of... Are necessary to get an individual benefit for them I 'd like to prescribe for will. Can often do this by increasing accessibility, reducing costs, or promoting self-efficacy beliefs Kalichman S. Predictors of antibody! Risk in combination with sufficient self-efficacy refers to an individual ’ s Ideas, convictions, attitudes about health health... A second benefit is the believed effectiveness of a behavior suffers from a of... Explain different levels of compliance with medical regimes or STD prevention, finding ways help... The health belief model ( HBM ) is a framework that helps whether. In Reference Module in Neuroscience and Biobehavioral Psychology, 2017 educators to design short- and long-term.! Much thought to be important in understanding various health behaviors, the coach can help learners reach appropriate about! Behavior change, has recently been integrated into HBM be effective in addressing the issue to predict behavior! Perceive that getting the needed dose of medicine could make their sex life better the proposed action long-term.!