|
Health
Belief Model
Welcome to
the Health Belief Model! In this section, you will find the following:
| Definition
and Rationale for the Health Belief Model |
The Health
Belief Model (HBM) is one of the most widely used conceptual frameworks
for understanding health behavior. Developed in the early 1950s, the model
has been used with great success for almost half a century to promote
greater condom use, seat belt use, medical compliance, and health screening
use, to name a few behaviors.
The HBM is
based on the understanding that a person will take a health-related action
(i.e., use condoms) if that person:
- feels that a negative health condition (i.e., HIV) can be avoided,
- has a positive expectation that by taking a recommended action, he/she
will avoid a negative health condition (i.e., using condoms will be
effective at preventing HIV), and
- believes that he/she can successfully take a recommended health action
(i.e., he/she can use condoms comfortably and with confidence).
The Health
Belief Model is a framework for motivating people to take positive health
actions that uses the desire to avoid a negative health consequence as
the prime motivation. For example, HIV is a negative health consequence,
and the desire to avoid HIV can be used to motivate sexually active people
into practicing safe sex. Similarly, the perceived threat of a heart attack
can be used to motivate a person with high blood pressure into exercising
more often.
It's important
to note that avoiding a negative health consequence is a key element of
the HBM. For example, a person might increase exercise to look good and
feel better. That example does not fit the model because the person is
not motivated by a negative health outcome — even though the health
action of getting more exercise is the same as for the person who wants
to avoid a heart attack.
The HBM
can be an effective framework to use when developing health education
strategies. A
large research study reviewed 46 studies of HBM-based prevention programs
published between 1974 and 1984. The HBM-based programs focused on a variety
of health actions. The results of the meta-analysis provided substantial
empirical support for the efficacy of the HBM. For more information on
this study, consult "The Health Belief Model and Personal Health
Behavior" (Becker, 1974). (See Resources
for a complete listing.)
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| Health
Belief Model: Major Concepts |
HBM is based
on six key concepts. The following table, excerpted with minor modifications
from "Theory at a Glance: A Guide for Health Promotion Practice"
(1997), presents definitions and applications for each of the six key
concepts. Examples of the concepts as they apply to sexuality education
are presented after this table.
|
Concept
|
Definition
|
Application
|
| 1.
Perceived Susceptibility |
One's
belief of the chances of getting a condition |
-
Define
population(s) at risk and their risk levels
- Personalize
risk based on a person's traits or behaviors
-
Heighten
perceived susceptibiity if too low
|
| 2.
Perceived Severity |
One's
belief of how serious a condition and its consequences are |
- Specify and describe consequences of the risk and the condition
|
| 3.
Perceived Benefits |
One's
belief in the efficacy of the advised action to reduce risk or seriousness
of impact |
- Define action to take — how, where, when
- Clarify the positive effects to expected
- Describe evidence of effectiveness
|
| 4.
Perceived Barriers |
One's
belief in the tangible and psychological costs of the advised behavior |
- Identify and reduce barriers through reassurance, incentives,
and assistance
|
| 5.
Cues to Action |
Strategies
to activate "readiness" |
- Provide how-to information
- Promote awareness
- Provide reminders
|
| 6.
Self-Efficacy |
Confidence
in one's ability to take action |
- Provide training, guidance, and positive reinforcement
|
For examples
of what the six key concepts look like when applied to two sexual health
actions, review the following table:
|
Concept
|
Condom
Use Education Example
|
STI
Screening or HIV Testing
|
| 1.
Perceived Susceptibility |
Youth
believe they can get STIs or HIV or create a pregnancy. |
Youth
believe they may have been exposed to STIs or HIV. |
| 2.
Perceived Severity |
Youth
believe that the consequences of getting STIs or HIV or creating a
pregnancy are significant enough to try to avoid. |
Youth
believe the consequences of having STIs or HIV without knowledge
or treatment are significant enough to try to avoid.
|
| 3.
Perceived Benefits |
Youth
believe that the recommended action of using condoms would protect
them from getting STIs or HIV or creating a pregnancy. |
Youth
believe that the recommended action of getting tested for STIs and
HIV would benefit them — possibly by allowing them to get early
treatment or preventing them from infecting others.
|
| 4.
Perceived Barriers |
Youth
identify their personal barriers to using condoms (i.e., condoms
limit the feeling or they are too embarrassed to talk to their partner
about it) and explore ways to eliminate or reduce these barriers
(i.e., teach them to put lubricant inside the condom to increase
sensation for the male and have them practice condom communication
skills to decrease their embarrassment level).
|
Youth
identify their personal barriers to getting tested (i.e., getting
to the clinic or being seen at the clinic by someone they know)
and explore ways to eliminate or reduce these barriers (i.e., brainstorm
transportation and disguise options).
|
| 5.
Cues to Action |
Youth
receive reminder cues for action in the form of incentives (such as
pencils with the printed message "no glove, no love") or
reminder messages (such as messages in the school newsletter). |
Youth
receive reminder cues for action in the form of incentives (such
as a key chain that says, "Got sex? Get tested!") or reminder
messages (such as posters that say, "25% of sexually active
teens contract an STI. Are you one of them? Find out now").
|
| 6.
Self-Efficacy |
Youth
receive training in using a condom correctly. |
Youth
receive guidance (such as information on where to get tested) or
training (such as practice in making an appointment).
|
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