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HealthBeliefModel

TheorienoverzichtTCW

InterpersonalCommunicationandRelations|OrganizationalCommunication|MassMedia|Communication
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HEALTHBELIEFMODEL
explaininghealthbehaviors
HistoryandOrientation
TheHealthBeliefModel(HBM)isapsychologicalmodelthatattemptstoexplainandpredicthealth
behaviors.Thisisdonebyfocusingontheattitudesandbeliefsofindividuals.TheHBMwasfirst
developedinthe1950sbysocialpsychologistsHochbaum,RosenstockandKegelsworkingintheU.S.
PublicHealthServices.Themodelwasdevelopedinresponsetothefailureofafreetuberculosis(TB)
healthscreeningprogram.Sincethen,theHBMhasbeenadaptedtoexploreavarietyoflongandshort
termhealthbehaviors,includingsexualriskbehaviorsandthetransmissionofHIV/AIDS.
CoreAssumptionsandStatements
TheHBMisbasedontheunderstandingthatapersonwilltakeahealthrelatedaction(i.e.,use
condoms)ifthatperson:
1.

feelsthatanegativehealthcondition(i.e.,HIV)canbeavoided,

2.

hasapositiveexpectationthatbytakingarecommendedaction,he/shewillavoidanegativehealth
condition(i.e.,usingcondomswillbeeffectiveatpreventingHIV),and

3.

believesthathe/shecansuccessfullytakearecommendedhealthaction(i.e.,he/shecanuse
condomscomfortablyandwithconfidence).

TheHBMwasspelledoutintermsoffourconstructsrepresentingtheperceivedthreatandnetbenefits:
perceivedsusceptibility,perceivedseverity,perceivedbenefits,andperceivedbarriers.Theseconcepts
wereproposedasaccountingforpeople's"readinesstoact."Anaddedconcept,cuestoaction,would
activatethatreadinessandstimulateovertbehavior.ArecentadditiontotheHBMistheconceptofself
efficacy,orone'sconfidenceintheabilitytosuccessfullyperformanaction.Thisconceptwasaddedby
Rosenstockandothersin1988tohelptheHBMbetterfitthechallengesofchanginghabitualunhealthy
behaviors,suchasbeingsedentary,smoking,orovereating.
TablefromTheoryataGlance:AGuideforHealthPromotionPractice"(1997)
Concept

Definition

Application

Perceived
Susceptibility

One'sopinionofchances
ofgettingacondition

Definepopulation(s)atrisk,risk
levelspersonalizeriskbasedona
person'sfeaturesorbehavior
heightenperceivedsusceptibilityif
toolow.

Perceived
Severity

One'sopinionofhow
seriousaconditionandits
consequencesare

Specifyconsequencesoftherisk
andthecondition

Perceived
Benefits

One'sbeliefintheefficacy
oftheadvisedactionto
reduceriskorseriousness
ofimpact

Defineactiontotakehow,where,
whenclarifythepositiveeffectsto
beexpected.

Perceived
Barriers

One'sopinionofthe
tangibleandpsychological
costsoftheadvisedaction

Identifyandreducebarriers
throughreassurance,incentives,
assistance.

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HealthBeliefModel

CuestoAction

Strategiestoactivate
"readiness"

Providehowtoinformation,
promoteawareness,reminders.

SelfEfficacy

Confidenceinone'sability
totakeaction

Providetraining,guidancein
performingaction.

ConceptualModel

Source:Glanzetal,2002,p.52
FavoriteMethods
Surveys.
ScopeandApplication
TheHealthBeliefModelhasbeenappliedtoabroadrangeofhealthbehaviorsandsubjectpopulations.
Threebroadareascanbeidentified(Conner&Norman,1996):1)Preventivehealthbehaviors,which
includehealthpromoting(e.g.diet,exercise)andhealthrisk(e.g.smoking)behaviorsaswellas
vaccinationandcontraceptivepractices.2)Sickrolebehaviors,whichrefertocompliancewith
recommendedmedicalregimens,usuallyfollowingprofessionaldiagnosisofillness.3)Clinicuse,which
includesphysicianvisitsforavarietyofreasons.
Example
Thisisanexamplefromtwosexualhealthactions.
(http://www.etr.org/recapp/theories/hbm/Resources.htm)
Concept

CondomUseEducationExample

1.Perceived
Susceptibility

YouthbelievetheycangetSTIsor
HIVorcreateapregnancy.

2.PerceivedSeverity

Youthbelievethatthe
consequencesofgettingSTIsor
HIVorcreatingapregnancyare
significantenoughtotrytoavoid.

3.PerceivedBenefits

Youthbelievethatthe
recommendedactionofusing
condomswouldprotectthemfrom
gettingSTIsorHIVorcreatinga
pregnancy.

STIScreeningorHIVTesting
Youthbelievetheymayhavebeen
exposedtoSTIsorHIV.
Youthbelievetheconsequencesof
havingSTIsorHIVwithoutknowledge
ortreatmentaresignificantenoughto
trytoavoid.
Youthbelievethattherecommended
actionofgettingtestedforSTIsand
HIVwouldbenefitthempossiblyby
allowingthemtogetearlytreatmentor
preventingthemfrominfectingothers.

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4.PerceivedBarriers

HealthBeliefModel

Youthidentifytheirpersonalbarriers
tousingcondoms(i.e.,condoms
limitthefeelingortheyaretoo
embarrassedtotalktotheirpartner
aboutit)andexplorewaysto
eliminateorreducethesebarriers
(i.e.,teachthemtoputlubricant
insidethecondomtoincrease
sensationforthemaleandhave
thempracticecondom
communicationskillstodecrease
theirembarrassmentlevel).

5.CuestoAction

Youthreceiveremindercuesfor
actionintheformofincentives
(suchaspencilswiththeprinted
message"noglove,nolove")or
remindermessages(suchas
messagesintheschoolnewsletter).

6.SelfEfficacy

Youthconfidentinusingacondom
correctlyinallcircumstances.

Youthidentifytheirpersonalbarriersto
gettingtested(i.e.,gettingtotheclinic
orbeingseenattheclinicbysomeone
theyknow)andexplorewaysto
eliminateorreducethesebarriers(i.e.,
brainstormtransportationanddisguise
options).

Youthreceiveremindercuesforaction
intheformofincentives(suchasakey
chainthatsays,"Gotsex?Gettested!")
orremindermessages(suchasposters
thatsay,"25%ofsexuallyactiveteens
contractanSTI.Areyouoneofthem?
Findoutnow").
Youthreceiveguidance(suchas
informationonwheretogettested)or
training(suchaspracticeinmakingan
appointment).

References
Keypublications
Conner,M.&Norman,P.(1996).PredictingHealthBehavior.SearchandPracticewithSocialCognition
Models.OpenUniversityPress:Ballmore:Buckingham.
Glanz,K.,Rimer,B.K.&Lewis,F.M.(2002).HealthBehaviorandHealthEducation.Theory,Research
andPractice.SanFransisco:Wiley&Sons.
Glanz,K.,MarcusLewis,F.&Rimer,B.K.(1997).TheoryataGlance:AGuideforHealthPromotion
Practice.NationalInstituteofHealth.
Eisen,Met.al.(1992).AHealthBeliefModelSocialLearningTheoryApproachtoAdolescents'
FertilityControl:FindingsfromaControlledFieldTrial.HealthEducationQuarterly.Vol.19.
Rosenstock,I.(1974).HistoricalOriginsoftheHealthBeliefModel.HealthEducationMonographs.Vol.
2No.4.
Becker,M.H.TheHealthBeliefModelandPersonalHealthBehavior.HealthEducationMonographs.
Vol.2No.4.
Champion,V.L.(1984).Instrumentdevelopmentforhealthbeliefmodelconstructs,AdvancesinNursing
Science,6,7385.
Becker,M.H.,Radius,S.M.,&Rosenstock,I.M.(1978).Compliancewithamedicalregimenforasthma:
atestofthehealthbeliefmodel,PublicHealthReports,93,26877.
Seealso:http://www.comminit.com/ctheories/sld2929.html
http://www.etr.org/recapp/theories/hbm/
Seealso:TheoryofPlannedBehavior/ReasonedAction,ProtectionMotivationTheory
SeealsoHealthCommunication

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