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How the Health Belief Model was Developed The HBM was first developed in the 1950s by social psychologists Godfrey Hochbaum, Irwin Rosenstock, and Stephen Kegels working in the U.S. Public Health Services. The model was developed in response to the failure of a free tuberculosis (TB) health screening program. The TB screening program provided adults with free TB screening x-rays from mobile units conveniently located in various neighborhoods. When few adults came out for the free services, program organizers began investigating why more adults did not come out. Hochbaum, however, began to study what motivated the few who did come out. He quickly learned that their perceived risk of disease and perceived benefits of action were crucial factors in their motivation. The model was first presented with only four key concepts: Perceived Susceptibility, Perceived Severity, Perceived Benefits, and Perceived Barriers. The concept of Cues for Action was added later to "stimulate behavior." Finally, in 1988, the concept of Self-Efficacy was added to address the challenges of habitual unhealthy behaviors such as smoking and overeating.
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