Health Belief Models

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Health Belief Model (HBM)
The Health Belief Model (HBM) is a psychological model that attempts to explain and predict health behaviors by focusing on the attitudes and beliefs of individuals. The HBM was developed in the 1950s as part of an effort by social psychologists in the United States Public Health Service to explain the lack of public participation in health screening and prevention programs (e.g., a free and conveniently located tuberculosis screening project). Since then, the HBM has been adapted to explore a variety of long- and short-term health behaviors, including sexual risk behaviors and the transmission of HIV/AIDS. The key variables of the HBM are as follows (Rosenstock, Strecher and Becker, 1994):

•Perceived Threat: Consists of two parts: perceived susceptibility and perceived severity of a health condition.
• Perceived Susceptibility: One's subjective perception of the risk of contracting a health condition,
•Perceived Severity: Feelings concerning the seriousness of contracting an illness or of leaving it untreated (including evaluations of both medical and clinical consequences and possible social consequences).

•Perceived Benefits: The believed effectiveness of strategies designed to reduce the threat of illness.
•Perceived Barriers: The potential negative consequences that may result from taking particular health actions, including physical, psychological, and financial demands.
• Cues to Action: Events, either bodily (e.g., physical symptoms of a health condition) or environmental (e.g., media publicity) that motivate people to take action. Cues to actions is an aspect of the HBM that has not been systematically studied.

•Other Variables: Diverse demographic, sociopsychological, and structural variables that affect an individual's perceptions and thus indirectly influence health-related behavior.

•Self-Efficacy: The belief in being able to successfully execute the behavior required to produce the desired outcomes. (This concept was introduced by Bandura in 1977.)
Implications for Health Behaviors
HBM research has been used to explore a variety of health behaviors in diverse populations.
•influenza inoculations,
•Tay-Sachs carrier status screening,
•high blood pressure screening,
•smoking cessation,
•seatbelt usage,
•breast self-examination.
•sexual risk behaviors
•general population
homosexual men
•pregnant women
Researchers are suggesting that an individual's perceived
ability to successfully carry out a "health" strategy, such as using a condom consistently, greatly influences his/her decision and ability to enact and sustain a changed behavior (Bandura, 1989).

General limitations of the HBM include:
a) most HBM-based research has incorporated only selected components of the HBM, thereby not testing the the model as a whole; b) as a psychological model it does not take into consideration other factors, such as environmental or economic factors, that may influence health behaviors; c) the model does not incorporate the influence of social norms and peer influences on people's decisions regarding their health behaviors (a point to consider especially when working with adolescents on HIV/AIDS issues). [pic]

Source: Rosenstock I., Strecher, V., and Becker, M. (1994). The Health Belief Model and HIV risk behavior change. In R.J. DiClemente and J.L. Peterson (Eds.), Preventing AIDS: Theories and methods of behavioral interventions (pp. 5-24). New York : Plenum Press.

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