The Health Belief Model: Theories and Applications to Promote Healthy Behavior

What are the psychological and social variables that have an effect on the physiological/biological state? What prevention and intervention programs would be adequate and effective for specific demographics? How/What specific influences would be valuable in promoting healthy choices? How should clinicians address and treat disease? Lastly, how can people be persuaded to change their unhealthy habits into healthy ones? Applied social psychology and more specifically, health psychology seek to answer these questions and apply psychological theories and knowledge to promote healthy behaviors. One of the main theories used to help communities and find solutions is the health belief model. (Gruman, 189-203)

The health belief model (HBM) was developed by social psychologists in the 1950’s. It is meant to account for various factors that may be influenced by human cognitions and beliefs. The HBM theorizes that these factors have influence over “health-related behaviors” These factors include: ”general health values, perceived susceptibility to illness, perceptions of illness severity, expectation of treatment success, self-efficacy, perceived barriers and benefits, and cues to action.” (Gruman, 203) 

Components/Factors of HBM:

General health values: The HBM operates under the assumption that most if not all humans have some concern about their health. 

Perceived susceptibility to illness: This is how and to what degree a person perceives a health risk. This depends on their knowledge of the disease and their personal connection to it. 

Perceptions of illness severity: “indicates whether we think the health threat is serious enough to warrant our taking action.“ (Gruman,204)

Expectation of treatment success: ““If we change this particular behavior, how likely is it that doing so will reduce this particular health threat?” …. If we do not think that our actions will make a difference, we probably will not be motivated to change our health behavior.” (Gruman, 204)

Self-efficacy: A human’s belief in themselves and in whether or not they can change their behavior. 

Perceived barriers and benefits: “Cost benefit analysis of changing health behavior…..Humans will weigh the positives of changing health behaviors vs. the perceived obstacles and inconveniences.” (Gruman, 204)

Cues to action: “Triggers, messages” or warnings that are effective in getting people to adopt healthy behaviors. (Gruman, 205)

Many interventions and studies have used the HBM as a framework. One of these studies is, Understanding HIV Testing Behaviors of Minority Adolescents: A Health Behavior Model Analysis. In this study researchers apply the HBM to analyze HIV testing behaviors of minority adolescents and seek to find effective interventions to encourage minority youths to test for HIV. “Adolescents and young adults (13–24 years of age) are the fastest-growing age group of HIV-infected individuals in the United States and HIV disproportionately affects minorities, as compared to whites” (CDC)  This study conducted a focus-group with 41 minority adolescents to assess their beliefs and attitudes towards HIV testing. (Schnall)

Adolescents reported that among the factors influencing their health behaviors, only fifteen percent felt that they were likely to contract the virus in their lifetimes, and many were concerned with the stigma and anxiety associated with getting tested for the virus. Also participants reported there were little to no cues to action and health care providers and/or guardians only seem to promote testing if they were sexually active. They stated that they never received any reminders or advertisements to seek out testing. Researchers concluded that future interventions were needed to make testing more accessible and to increase knowledge about HIV resources. (Schnall)

The HBM is clearly a valuable tool of intervention for reducing and changing unhealthy behaviors. However, as with anything it is not without its shortcomings. Some studies that have followed this theoretical model’s framework have not found “supportive” results and a few psychologists have critiqued the HBM for only “listing factors that affect health behaviors, not explaining direct relationships. Luckily (or perhaps not) the “HBM has the ability to be operationalized in different ways.” (Gruman, 205) More work is definitely needed in this theoretical subfield before it can be applied. 

References:

Gruman, J. A., Schneider, F. W., & Coutts, L. M. (2017). Applied Social Psychology; Understanding and Addressing Social and Practical Problems.Los Angeles: SAGE Publications, Inc

Schnall, R., Rojas, M., & Travers, J. (2015). Understanding HIV testing behaviors of minority adolescents: a health behavior model analysis. The Journal of the Association of Nurses in AIDS Care : JANAC, 26(3), 246–258. https://doi.org/10.1016/j.jana.2014.08.005

 

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