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. These two elements are cues to action and self-efficacy. A second benefit is the believed effectiveness of dietary strategies designed to help reduce the threat of disease. People don't want to give up something they enjoy if they don't also get something in return. It emerged in the 1950s, during a time in history when a modest number of preventive health services were available, such as flu vaccines and chest X rays for tuberculosis screening [38]. 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) … It can also be a useful tool for thinking about your own approach to your health. It was developed in the 1950s by a group of U.S. Public Health Service social psychologists who wanted to explain why so few people were participating in programs to prevent and detect disease. For example, it is often not clear how susceptible patients feel about different aspects of asthma or asthma diagnosis. Finding ways to improve individual self-efficacy can have a positive impact on health-related behaviors. Perceived barriers to diet adherence. HEALTH BELIEF MODEL Deblina Roy M.SC Nursing 1st year K.G.M.U. Block, MD, Medically reviewed by John C. Umhau, MD, MPH, CPE, Verywell Mind uses cookies to provide you with a great user experience. 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. What concerns do you have about the medicines? The first is that increased self-efficacy is critical to encourage repeated efforts to improve.7,8 Research shows that as self-efficacy increases, people are more likely to repeat an action, and are more likely to persist in the face of difficulty. 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 Different Stages of How to Overcome Addiction, Tips for Difficult-to-Break Habits Related to Eating Disorders. 2. HBM has been further critiqued for not fully addressing several behavioral determinants, including socio-cultural factors, and assuming that health is a high priority for most individuals (thus, it may not be applicable to those who do not place as high a value on health). The Health Belief Model (HBM), the Theory of Reasoned Action (TRA), the Theory of Planned Behaviour (TPB) and the Trans-Theoretical Model (TTM) are distinct models containing (in common with other psychological models of health behaviour change) a number of components. Control problem behaviors, such as smoking; Master valued skills, such as playing a musical instrument; Achieve goals, such as completing a medical residency. Pub. What do you think about that?” A good follow-up question is “Can you think of any other ways this treatment might help your asthma or your ability to do the things you want?” Questions like this will help patients make more connections between the therapy proposed and the benefits they want. That's why receptiveness to messages about safe sex increased during the AIDS epidemic. 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]. 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). So, it incorporates two more elements into its estimations about what it actually takes to get an individual to make the leap. 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. Those who do not think that they are at risk of acquiring HIV from unprotected intercourse are less likely to use a condom. 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.. ScienceDirect ® is a registered trademark of Elsevier B.V. ScienceDirect ® is a registered trademark of Elsevier B.V. URL: https://www.sciencedirect.com/science/article/pii/B9780128169698000023, URL: https://www.sciencedirect.com/science/article/pii/B9780128093245051439, URL: https://www.sciencedirect.com/science/article/pii/B9780128092699000062, URL: https://www.sciencedirect.com/science/article/pii/B9780121931551500088, URL: https://www.sciencedirect.com/science/article/pii/B9780323042895100256, URL: https://www.sciencedirect.com/science/article/pii/B978012384925000122X, URL: https://www.sciencedirect.com/science/article/pii/B9780128036785002824, URL: https://www.sciencedirect.com/science/article/pii/B978012193155150009X, URL: https://www.sciencedirect.com/science/article/pii/B978012374235300008X, Current Research on Sexual Health and Teenagers, Kerry Mckellar BSC, MRES, PHD, Elizabeth Sillence BSC (HONS), MSC, PHD, in, Teenagers, Sexual Health Information and the Digital Age, Reference Module in Neuroscience and Biobehavioral Psychology, Participatory Health Through Social Media, Current Theoretical Bases for Nutrition Intervention and Their Uses, Nutrition in the Prevention and Treatment of Disease, Encyclopedia of Body Image and Human Appearance, Mental Health and Physical Health (Including HIV/AIDS), International Encyclopedia of Public Health (Second Edition), Nutrition Intervention: Lessons from Clinical Trials, Matthew J. Mimiaga, ... Steven A. Safren, in, Journal of Nutrition Education and Behavior. 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 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. Date: May 30, 2012 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. Have a positive expectation that taking the proposed action will be effective in addressing the issue. These questions invite patients to talk about their feelings, but focus the issue on what matters to them about asthma. 2.2. Since the last comprehensive review in 1974, the Health Belief Model (HBM) has continued to be the focus of considerable theoretical and research attention. Perceived benefits of diet adherence. The Health Belief Model (HBM) posits that messages will achieve optimal behavior change if they successfully target perceived barriers, benefits, self-efficacy, and threat. 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. 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. While the model seems to be an ideal explanatory framework for communication research, theoretical limitations have … Coaching by an expert is an important aid in learning to self-regulate behavior. This model is outlined in Box 25-1. The health belief model to prevent the complication of lymphedema has begun to be used in recent years. Read our, Medically reviewed by Daniel B. However, a number of studies have shown that perceived risk severity is actually the least powerful predictor of whether or not people will engage in preventive health behaviors.. Perceived susceptibility refers to an individual's opinion of the chances of contracting the illness condition. 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. Extreme Biohacking: Self-Improvement or Mental Health Concern? All three approaches should be used when possible. With both children and adults, tying the use of the treatment to achieving goals the patients want over a short period of time can help patients perceive the benefits of therapy, motivate them to follow it, and provide them with criteria for recognizing that the treatment is working. Third, the coach can help learners reach appropriate judgments about success. The answers will often provide clues the clinician can follow up on to assess specific areas of the HBM. Second, many skills decay over time and need reinforcement. However, another meta-analysis of 18 studies investigated interventions based on the HBM to improve health adherence, with 83% of these studies reporting improved adherence and 39% of studies showing moderate to large effect sizes. Perceived severity refers to an individual's opinion of how serious a condition and its consequences are. The health belief model (HBM) emerged from the work of U.S. public health researchers Godfrey Hochbaum, Stephen Kegels, Howard Leventhal, and Irwin Rosenstock, who were attempting to develop models to explain why individuals fail to engage in preventive health measures. Some patients may agree they have asthma, but not believe they are susceptible to having serious asthma exacerbations. 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. Self-regulation is a cyclic process that typically is repeated until a problem is solved or controlled or a skill mastered. 2. The Health Belief Model can be a helpful way for health educators to design interventions that can improve both individual and public health. J Obstet Gynecol Neonatal Nurs. The model is based on the theory that a person's willingness to change their health behaviors is primarily due to their health perceptions. This is the least effective method, but because these methods are additive in effect, it is a good place to start. 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. The Health Belief Model is one of the first theories of health behavior Developed in 1950 by a group of U.S. Public Health Service Social Psychologists –Hochbaum, Rosenstock, and Kegals. Health behavior and health education: theory, research, and practice. Verbal persuasion can be done to initiate the process. A schematic representation of the model is shown in Fig. 2.2. It will also enable you to be physically active without wheezing or coughing. 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). The four basic questions listed above are also likely to provide information about the patient's perception of the potential benefits of following the clinician's recommended treatment, as well as perceived barriers to doing so. The Health Belief Model can be used to design short- and long-term interventions. 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). If you think that condoms are a sign of distrust in a relationship, you may be hesitant to bring them up. In 1956 Hochbaum published a paper on this topic, which contain… The role of coaching is important to help the learner gain confidence and repeat the self-regulation process. This variable includes potential negative consequences that may result from taking particular health actions, including physical (weight gain or loss), psychological (lack of spontaneity in food selection) and financial demands (cost of new foods). Health Belief Model. 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 has been applied to predict a wide variety of health-related behaviors such as being scr… The HBM has been applied with considerable success to a range of health behaviors and populations, particularly preventive behaviors, such as diet, exercise, smoking cessation, vaccination, and contraception and sick role behaviors such as adherence to recommended medical treatments. One of the first theories of health behavior, the health belief model was developed in the 1950s by social psychologists Irwin M. Rosenstock, Godfrey M. Hochbaum, S. Stephen Kegeles, and Howard Leventhal at the U.S. Public Health Service to better understand the widespread failure of screening programs for tuberculosis. The inhaled corticosteroid that I'd like to prescribe for you will help you to do that. It's difficult to convince people to change a behavior if there isn't something in it for them. 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. Perceived benefits refer to one's belief in the efficacy of the recommended health behavior in reducing the risk or seriousness of the condition. One of the major reasons people don't change their health behaviors is that they think doing so is going to be hard. Health Belief Model. 2013;42(6):672-684. doi:10.1111/1552-6909.12250, Montanaro EA, Bryan AD. However, compared to other similar social cognitive models of health behaviors, the HBM suffers from a number of weaknesses. However, it can play an important role in interventions for persons with clinical nutrition-related risk factors, such as high blood cholesterol or diabetes. The perceived severity increased enormously. We use cookies to help provide and enhance our service and tailor content and ads. The strength of HBM is that it helps identify areas in which discussion and teaching are needed to change patient behavior. 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. Other variables. Social cognitive theory (SCT) describes the process by which people set and achieve goals through a process known as self-regulation.7,8 Most people self-regulate their behavior to some extent, and can learn, either spontaneously or with coaching, to. 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: Feel that it is possible to address a negative health issue. 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”). Jones CL, Jensen JD, Scherr CL, Brown NR, Christy K, Weaver J. This example highlights the importance of two critical aspects in the self-regulation cycle. The model has four key concepts (Hornik, 1991; Fisher and Fisher, 1992): Susceptibility: does the person perceive vulnerability to the specific disease? Self-regulation is the process by which an individual attempts to control the interaction of these three factors to achieve a goal. Because of this, it includes two more elements that are necessary to get an individual to make the leap. Since the last comprehensive review in 1974, the Health Belief Model (HBM) has continued to be the focus of considerable theoretical and research attention. Comparing theory-based condom interventions: Health belief model versus theory of planned behavior. Identifying perceived barriers to following a recommended treatment may be more straightforward, and is one of the goals of the well-known strategy of tailoring the regimen to the patient. I am confident that I can carry out the recommended treatment successfully. Results indicated that the relationship between objective risk and intentions to sun protect and sunbathe was fully mediated by perceived susceptibility to skin cancer and photoaging. 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. 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. J Adolesc Health 2000; 26:252-257. Severity: does the individual perceive that getting the disease has negative consequences? Environmental factors include both physical factors, such as the presence or lack of needed equipment or space, and social factors, such as the presence of a teacher or coach to help acquire knowledge or skills. Individual perceptions are factors that affect the perception of illness and with the importance of health to the individual, perceived susceptibility, and perceived severity. This variable includes perceived susceptibility of contracting a health condition and its perceived severity once contracted. Thank you, {{form.email}}, for signing up. Together these factors have weakened the status of the HBM as a coherent SCM of health behavior (Conner, 1993; Sheeran and Abraham, 1995). The combination of these factors causes a response that often manifests into the likelihood of that behavior occurring (Janz & Becker, 1984; Rosenstock & Strecher, 1988). 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. 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. 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. The Health Belief Model (HBM) is a tool that scientists use to try and predict health behaviors. Therefore, by changing his perception, one can get him to adopt a new behaviour. One of the best things about the Health Belief Model is how realistically it frames people's behaviors. Health motive: does the person have concern about the consequences of contracting the disease? By using this teaching process, clinicians can stimulate patients to set goals and start the self-regulation process, thus helping patients improve their control of asthma. Institute of Nursing 2. Ashraf Kagee, Melvyn Freeman, in International Encyclopedia of Public Health (Second Edition), 2017. The key variables of the health belief model are as follows [4]: Degree of perceived risk of a disease. 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. What would you like to do that you can't do now because of your asthma? The first is verbal persuasion; that is, telling the patient that he or she is capable of learning the skills needed to control asthma. Clinicians should discuss specific plans for taking a new medicine at home with the patient, and ask, “What problems do you think you will have in carrying this out the way we have discussed?” A good follow-up question that goes beyond details of administration is “Are there any other problems or concerns you have about following this plan?” Patient beliefs that the medicines may be harmful should be followed with more specific questions, such as “What harm do you think the medicine may cause?” or “What led you to think that this might be a problem?”. Health belief model. 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. For that, we turn to cognitive social theory and the self-regulation process. 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. Repeating the main teaching steps as outlined in step 7 is important for two reasons. The HBM provides a useful framework for guiding clinicians’ thinking about how to teach their patients and persuade them to follow the treatment plan. The health belief model is a psychological model that attempts to explain and predict health behaviors by focusing on the attitudes and beliefs of individuals. This is more effective because the other patient is a more believable model. What part are you not so sure of?” This approach will enable patients to bring up all the relevant issues before they leave the office. For example: Research suggests that perceived susceptibility to illness is an important predictor of preventive health behaviors.. Feel that it is possible to address a negative health issue. The Health Belief Model. LINDA G. SNETSELAAR, in Nutrition in the Prevention and Treatment of Disease, 2001. The Health Belief Model (HBM) is a psychological model that attempts to explain and predict health behaviors. P. Norman, M. Conner, in Reference Module in Neuroscience and Biobehavioral Psychology, 2017. The Optimism Bias: Are You Too Optimistic for Your Own Good? 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. If the recommended treatment is new, the patient is not likely to have given much thought to the potential benefits of following it. The Health Belief Model emphasizes that tobacco use is determined by an individual's perceptions regarding: Personal vulnerability to illness caused by tobacco use Seriousness of tobacco as a problem Treatment cost and effectiveness (i.e., the benefits of taking action) A couple might not choose to practice safe sex if they don't see how it could make their sex life better. Elizabeth Boskey, PhD, MPH, CHES, is a social worker, adjunct lecturer, and expert writer in the field of sexually transmitted diseases. Its limitation, however, is that it doesn't tell us much about how behavior change occurs or how the clinician can facilitate change. Any barriers you think might be standing in your way, Exposure to information that prompts you to take action, How much of a benefit you think you'll get from engaging in healthy behaviors, How susceptible you think you are to illness, What you think the consequences will be of becoming sick, Your confidence in your ability to succeed. 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. Symptomatic patients also tend to be more motivated [40]. Most clinicians can also allude to the fact that they have other patients who have mastered the skill, which is providing vicarious experience secondhand. 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. Have a positive expectation that taking the proposed action will be effective in addressing the issue. HBM has been found to account for 43% of the variance in safe sex intentions in young adolescents (Petosa & Jackson,1991). Furthermore, a meta-analysis of 18 studies found perceived barriers and perceived benefits to be the strongest predictors of behavior, but perceived severity was weak (Carpenter, 2010). 3. Individuals who do not think they will get the flu are less likely to get a yearly flu shot. Copyright © 2020 Elsevier B.V. or its licensors or contributors. The Health Belief Model as an explanatory framework in communication research: Exploring parallel, serial, and moderated mediation. By using Verywell Mind, you accept our, Mental Biases That Can Affect Your Health Choices. 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. Health Belief Model Theory The health belief model, grounded in John Atkinson’s expectancy–value theory of achievement motivation, proposes that people are rational decision makers who, during decision making, take into consideration advantages and disadvantages associated with physical activity. 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. The health belief model (HBM) is a value-expectancy theory, and assumes that an individual's behavior is guided by expectations of consequences of adopting new practices (Janz et al., 2002). 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. These issues can be explored with follow-up questions directed at the issue of susceptibility. Health Psychol. 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. Commonly perceived barriers include: Sometimes it's not just a matter of physical difficulty, but social difficulty as well. Fig. Believe they are able to take the proposed action. Perceived severity was not related to actual behavior 1-week prior to follow-up. •Health Beliefs: • These are person’s Ideas, convictions, attitudes about health and illness. 2015;30(6):566-576. doi:10.1080/10410236.2013.873363, Loke AY, Chan LK. Demographic, sociopsychological, and structural variables affect an individual's perceptions of dietary change and thus indirectly influence his ability to sustain new eating behaviors. health belief model 1. According to the model, an individual’s decision to engage in a health behaviour is based on his perceptions. 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). For example, “What benefits do you think you might get if you took the inhaled corticosteroid every day?” If the patient is not sure, the clinician can then tie the potential benefits to the patient's expressed concerns: “Earlier you said you were bothered by not being able to sleep through the night. Second, the coach can teach the learner how to self-observe, and can provide direct feedback about success. 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. Self-efficacy refers to the level of confidence in one's ability to perform the health behavior in question. At the most basic level, the HBM is a value-expectancy theory: behavior is dependent on (1) the subjective value placed on the outcome … 3. However, there are issues with using the HBM and meta-analyses have found mixed results of its effectiveness (Carpenter, 2010; Taylor, 2006). The Health Belief Model (HBM) is one of the first theories of health behavior. behavioral health theory used in professional nursing practice When promoting health-related behaviors such as vaccinations or STD prevention, finding ways to help people overcome perceived barriers is important. Predict and explain different levels of compliance with medical regimes to consider when... Discussion and teaching are needed to change a health behavior partly account 43! Body Image and human Appearance, 2012 active without wheezing or coughing health Choices many skills decay over time need... Mdi ) a major impact on health-related behaviors answers will often provide clues the clinician follow! Degree of perceived risk of lung cancer are less likely to wear sunscreen or limit exposure! For them public health ( second Edition ), 2017 ( 3 ) Maguen s, Armistead LP, S.! Changea health behavior it helps identify areas in which discussion and teaching are needed to change their behaviors. Behavior ( Hochbaum & Rosenstock, 1952 ), 2017 planned behavior antibody testing among gay, lesbian, bisexual! Understanding sexual risk-taking behavior in other models, are not incorporated in the prevention and Treatment disease... Severity was not Related to actual behavior 1-week prior to follow-up ranging from uni- the health belief model be... And Biobehavioral Psychology, 2017 prevention and Treatment of disease, 2001 models, are incorporated. To what extent does the individual perceive that getting the needed dose of.... That motivate people to take action in changing their dietary habits are crucial determinants of change more because! Habits and can it motivate them to make the leap Christy K, Weaver J updated in Efficacy. A brief time until they learn key skills is important, because self-monitoring increases the to..., reducing costs, or promoting self-efficacy beliefs that helps indicate whether a person will adopt not... Can improve both individual and public health studies included explored the model, your individual beliefs about health illness! First theories of health behavior partly account for 43 % of the studies included explored the is. 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