The Health Belief Model focuses on the individual level and a person’s motivations and attitudes to do or not to do a health behavior. For example, using the HBM we could understand why a person chooses to smoke, do drugs or practice unsafe sex. The model was developed in the 1950s by social scientists at the US Public Health Services, Hochbaum, Rosenstock and Kegels. Trying to identify why individuals failed to get screened for tuberculosis, an infectious disease that affects the lungs, these scientists identified four factors that contributed to person’s decision to make a behavior change. Two more factors were added on after further research into the HBM, for a total of six constructs (University of Pennsylvania, 2018). The six factors (perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, and self-efficacy) are accompanied by three core assumptions. First, a person will make a behavior change if they believe that a negative health condition can be avoided. Second, the individual must believe that making a said behavior change is effective in avoiding the negative health condition. Finally, the person must believe they can successfully make the behavior change. Seeing the model’s usefulness, the HBM has been used to address a variety of health behaviors other than screening. Today, it used for a range of health behaviors, primarily (1) preventive health behaviors, (2) sick role behaviors, (3) clinic use (University of Pennsylvania, 2018).
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 screening tests for the early detection of disease. Later uses of HBM were for patients' responses to symptoms and compliance with medical treatments. The HBM suggests that a person's belief in a personal threat of an illness or disease together with a person's belief in the effectiveness of the recommended health behavior or action will predict the likelihood the person will adopt the behavior. The HBM derives from psychological and behavioral theory with the foundation that the two components of health-related behavior are 1) the desire to avoid illness, or conversely get well if already ill; and, 2) the belief that a specific health action will prevent, or cure, illness. Ultimately, an individual's course of action often depends on the person's perceptions of the benefits and barriers related to health behavior. There are six constructs of the HBM. The first four constructs were developed as the original tenets of the HBM. The last two were added as research about the HBM evolved.
Limitations of Health Belief ModelThere are several limitations of the HBM which limit its utility in public health. Limitations of the model include the following:
The HBM is more descriptive than explanatory, and does not suggest a strategy for changing health-related actions. In preventive health behaviors, early studies showed that perceived susceptibility, benefits, and barriers were consistently associated with the desired health behavior; perceived severity was less often associated with the desired health behavior. The individual constructs are useful, depending on the health outcome of interest, but for the most effective use of the model it should be integrated with other models that account for the environmental context and suggest strategies for change. The Health Belief Model (HBM) was one of the first models that adapted theory from the behavioral sciences to health problems, and it remains one of the most widely recognized conceptual frameworks of health behavior. From: Travel Medicine (Second Edition), 2008
The Health Belief Model (HBM) is a tool that scientists use to try to predict health behaviors. It was originally developed in the 1950s and updated in the 1980s. The model is based on the theory that a person's willingness to change their health behaviors primarily comes from their health perceptions. According to this model, your individual beliefs about health and health conditions play a role in determining your health-related behaviors. Key factors that affect your approach to health include:
Health experts often look for ways that Health Belief Models can affect the actions people take, including behaviors that can have an impact on both individual and public health. This article discusses how the Health Belief Model works, the different components of the model, and how this approach can be used to address health-related behaviors. There are six main components of the Health Belief Model. Four of these were main tenets of the theory when it was first developed. Two were added in response to research on the model related to addiction. The probability that a person will change their health behaviors to avoid a consequence depends on how serious they believe the consequences will be. For example:
The severity of an illness can have a major impact on health outcomes. However, a number of studies have shown that perceived risk of severity is actually the least powerful predictor of whether or not people will engage in preventive health behaviors. People will not change their health behaviors unless they believe that they are at risk. For example:
Research suggests that perceived susceptibility to illness is an important predictor of preventive health behaviors. It's difficult to convince people to change a behavior if there isn't something in it for them. People don't want to give up something they enjoy if they don't also get something in return. For example:
These perceived benefits are often linked to other factors, including the perceived effectiveness of a behavior. If you believe that getting regular exercise and eating a healthy diet can prevent heart disease, that belief increases the perceived benefits of those behaviors. One of the major reasons people don't change their health behaviors is that they think doing so is going to be hard. Changing health behaviors can require effort, money, and time. Commonly perceived barriers include:
Sometimes it's not just a matter of physical difficulty, but social difficulty as well. For example, If everyone from your office goes out drinking on Fridays, it may be very difficult to cut down on your alcohol intake. If you think that condoms are a sign of distrust in a relationship, you may be hesitant to bring them up.
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. When promoting health-related behaviors such as vaccinations or STD prevention, finding ways to help people overcome perceived barriers is important. Disease prevention programs can often do this by increasing accessibility, reducing costs, or promoting self-efficacy beliefs. One of the best things about the Health Belief Model is how realistically it frames people's behaviors. It recognizes the fact that sometimes wanting to change a health behavior isn't enough to actually make someone do it. Because of this, it includes two more elements that are necessary to get an individual to make the leap. These two elements are cues to action and self-efficacy. Cues to action are external events that prompt a desire to make a health change. They can be anything from a blood pressure van being present at a health fair, to seeing a condom poster on a train, to having a relative die of cancer. A cue to action is something that helps move someone from wanting to make a health change to actually making the change. Self-efficacy wasn't added to the model until 1988. Self-efficacy looks at a person's belief in their ability to make a health-related change. It may seem trivial, but faith in your ability to do something has an enormous impact on your actual ability to do it. Finding ways to improve individual self-efficacy can have a positive impact on health-related behaviors. For example, one study found that women who had a greater sense of self-efficacy toward breastfeeding were more likely to nurse their infants longer. The researchers concluded that teaching mothers to be more confident about breastfeeding would improve infant nutrition. Thinking that you will fail will almost make certain that you do. Self-efficacy has been found to be one of the most important factors in an individual's ability to successfully negotiate condom use.
There are six components of the Health Belief Model. They are perceived severity, perceived susceptibility, perceived benefits, perceived barriers, cues to action, and self-efficacy. It can be helpful to look at how the Health Belief Model can be applied in different situations. One important aspect of public health is the design of programs that encourage people to engage in healthy behaviors, so understanding how this model can be applied to different situations can be useful. For example, experts may be interested in understanding public attitudes about cancer screenings. Looking at factors like perceptions of the risk of getting cancer, the benefits of being screened for cancer, and the barriers to being screened can help healthcare professionals look for ways to encourage people to get screened. The model may also be used for public health programs that are used in different settings. Schools, for example, may rely on educational programs to help children understand challenges regarding health, substance use, physical activity, nutrition, and personal safety. Such programs are often based on the Health Belief Model and work to educate, offer skills training, reduce barriers, and boost self-efficacy.
Healthcare professionals and public health experts can apply the Health Belief Model to create programs and interventions designed to help prevent health problems, encourage treatment behaviors, and support behavior change. The Health Belief Model has been used for decades to help produce behavior change interventions. Research suggests that the Health Belief Model can be helpful for designing strategies to help promote healthy behaviors and to improve the prevention and treatment of health conditions. In a study published in the journal Health Psychology Review, researchers found that in studies looking at the Health Belief Model, 78% reported significant improvement in behavior adherence. Of the studies they looked at, 39% reported moderate to large effects related to health interventions. The Health Belief Model is not without criticism. Some of the limitations of this approach to understanding health include:
Critics also suggest that the model focuses on describing health behaviors rather than explaining how to change them.
Some limitations of the Health Belief Model include it does not adequately address some of the individual factors that affect health behaviors. It also fails to account for how environmental factors, including social variables, impact a person's health choices. The Health Belief Model can be a helpful way for health educators to design interventions that can improve both individual and public health. By understanding the factors that influence the health choices people make, programs can tackle ways to reduce barriers, improve knowledge, and help people feel more motivated to take action. It can also be a useful tool for thinking about your own approach to your health. Consider how things such as perceived susceptibility, perceived barriers, self-efficacy, and other elements of the model influence your choices, then look for things that you can do to make healthier choices in your life. Frequently Asked Questions
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