The Health Belief Model (HBM) is a psychological model that attempts to explain and predict health behaviors. This is done by focusing on the attitudes and beliefs of individuals. The HBM was first developed in the 1950s by social psychologists Hochbaum, Rosenstock and 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. 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.
Core Assumptions and Statements
The HBM is based on the understanding that a person will take a health-related action (i.e., use condoms) if that person: 1.feels that a negative health condition (i.e., HIV) can be avoided, 2.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 3.believes that he/she can successfully take a recommended health action (i.e., he/she can use condoms comfortably and with confidence).
The HBM was spelled out in terms of four constructs representing the perceived threat and net benefits: perceived susceptibility, perceived severity, perceived benefits, and perceived barriers. These concepts were proposed as accounting for people’s “readiness to act.” An added concept, cues to action, would activate that readiness and stimulate overt behavior. A recent addition to the HBM is the concept of self-efficacy, or one’s confidence in the ability to successfully perform an action. This concept was added by Rosenstock and others in 1988 to help the HBM better fit the challenges of changing habitual unhealthy behaviors, such as being sedentary, smoking, or overeating. Table from “Theory at a Glance: A Guide for Health Promotion Practice” (1997)
Concept Definition Application
Perceived Susceptibility One’s opinion of chances of getting a condition Define population(s) at risk, risk levels; personalize risk based on a person’s features or behavior; heighten perceived susceptibility if too low. Perceived SeverityOne’s opinion of how serious a condition and its consequences are Specify consequences of the risk and the condition 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 be expected. Perceived Barriers One’s opinion of the tangible and psychological costs of the advised actionIdentify and reduce barriers through reassurance, incentives, assistance. Cues to ActionStrategies to activate “readiness”Provide how-to information, promote awareness, reminders. Self-Efficacy Confidence in one’s ability to take actionProvide training, guidance in performing action.