Health Belief Model Analysis

One of my assignments in this course was to complete a literature review on one of the individual health behavior theories. I selected the Health Belief Model (HBM), mostly because of my background and interest in social psychology. I will continue to discuss this theory and its application to both maternal health and stress prevention in the next two posts. Meanwhile, the following is background information and my analysis of HBM: 

Developed by leading social psychologists in the 1950s, the Health Belief Model (HBM) has been a popular model used in public health. This is a behavioral theory used to explain individuals’ perceptibility of a potential health problem (NCI, 2005). HBM is rooted in both cognitive and stimulus-response theories. Stimulus-response theorists posited that consequences of behaviors are learned and eventually, reduce physiological drives that initiate a behavior (Champion & Skinner, 2008, p. 46). Contrary to this notion, cognitive theorists believed that a certain behavior is a mere result of subjective value of an outcome and expectation that the behavior will achieve a particular outcome, also known as value-expectancy theory. According to  cognitive theory, reinforcements influence expectations about a situation, but do not directly influence behavior (Champion & Skinner, 2008, p. 46). In terms of health-related behavior, value-expectancy was defined as: value of avoiding diseases and getting well and the expectation that a specific health action may prevent or alleviate disease burden (Champion & Skinner, 2008, p.46). Today, these concepts are known as perceived susceptibility and perceived severity, respectively, two of the six HBM constructs.

HBM is an investigative model used to explain why people are either encouraged or discouraged from engaging in health-sustaining behaviors (NCI, 2005). The six constructs are perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action and self-efficacy. Cues to action and self-efficacy are the most recent constructs. Self-efficacy was added in 1988 and is based on Social Learning Theory (Edberg, 2007, p. 36). Perceived susceptibility is the “degree to which a person feels at risk for a health problem” (Edberg, 2007, p. 37). If a person believes he or she is at risk, then, he or she may perform certain behaviors to avert a negative health outcome. Second, perceived severity is the “degree to which a person believes the consequences of the health problem are severe” (Edberg, 2007, p. 37). The person is either aware or unaware of the severity of the disease or illness, which also influences action. The third construct, perceived benefits, are the positive outcomes the individual knows to be a result of the behavior (Edberg, 2007, p. 37). If someone believes that performing a certain behavior will benefit their health status, they are likely to perform that behavior, vice versa. Conversely, the fourth construct, perceived barriers, states that the individual knows negative outcomes will result from an action (Edberg, 2007, p. 37). Cues to action refers to the events that motivate the individual to act (Edberg, 2007, p. 37). Finally, the self-efficacy construct, used for many health behavior theories, is one’s belief in his or her ability to act (Edberg, 2007, p. 37). Self-efficacy involves a person’s skill and will to take an action.

Click here to view an illustration of the Health Belief Model.  

                                       

There are several things to consider when using the HBM for a health promotion program. The aforementioned constructs are abstract and should only be used as guides or influences on behavior. This error is known as the EZ program structure illusion (Edberg, 2007, p. 37). In order to avoid this, program planners must conduct extensive research on the target population and not to rely solely on the theory or model; effective programs are beyond theory and models alone. It takes real world information, resources and materials to understand the potential efficaciousness of a program based on any behavioral health theory or model. It is imperative to also note the shortcomings of the HBM, too. First, it does not address social and environmental factors that influence individuals’ behaviors. Secondly, it assumes that all people have equal access to and the opportunity to have the necessary resources and information to make rational decisions (Edberg, 2007, p. 38). As Edberg stated, it is the obligation of health program planners to select and apply the most appropriate theories and models.

REFERENCES

Champion, V.L. & Skinner, C.S. (2008). The Health Belief Model. In Glanz, K (Ed.4), Health Behavior and Health Education (pp. 45-65). San Francisco: Jossey-Bass.

Edberg, M. (2007). Individual Health Behavior Theories. In Birtcher, K. (Ed.), Essentials of

            Health Behavior: Social and Behavioral Theory in Public Health (pp. 35-47). Sudbury,

            MA: Jones & Bartlett.

National Cancer Institute. (2005). Theory at a glance: a guide for health promotion practice (2 ed.), p. 9-18.