HEALTH BELIEF MODEL:

• The health belief model is a psychological health behavior change model developed to explain and
predict health related behaviors. Proposed by Irwin M. Rosenstock and Backer.
• The Health Belief Model (HBM) was developed in the early 1950s by social scientists at the U.S.
Public Health Service in order to understand the failure of people to adopt disease prevention
strategies or screening tests for the early detection of disease.
• The health belief model proposes that a person's health- related behavior depends on the person's
perception of four critical areas:
1. The severity of a potential illness
2. The person's susceptibility to that illness
3. The benefits of taking a preventive action
4. The barriers to taking that action
• Health Belief Model (HBM) is a conceptual formulation for understanding why individuals did or
did not engage in a wide variety of health related actions.
• Four constructs (perceived susceptibility, perceived severity, perceived benefits, and perceived
barriers) - fairly good predictor of screening behavior. These concepts were proposed as accounting
for people's "readiness to act."
• Later additional constructs added to better explain changing habitual behaviors
1. cues to action, would activate that readiness and stimulate overt behaviour.
2. self-efficacy, or one's confidence in the ability to successfully perform an action.
1. Perceived susceptibility:
• It refers to subjective assessment of risk of developing a health problem.
• Individuals with low perceived susceptibility, deny that they are at risk for contracting a particular
illness.
• This model predicts that individuals who perceive that they are susceptible to a particular health
problem will engage in behaviors to reduce their risk of developing the health problem.
• Individuals who believe they are at low risk of developing an illness are more likely to engage in
unhealthy, or risky, behaviors.
• E.g.: a man who, based on family history, believe he is likely candidate for heart disease is more
likely to pay attention to an advertisement for a program to reduce the risk of heart disease.
• Perceived severity + perceived susceptibility = perceived threat.
2. Perceived severity
• Beliefs about the seriousness of a condition and its consequences
- disability
- death
- pain
• Individuals who perceive a given health problem as serious are more likely to engage in behaviors
to prevent the health problem from occurring (or reduce its severity).
• Eg: a person newly diagnosed with diabetes may not be likely to make major life or diet changes if
he or she is not experiencing any symptoms.
• An individual may perceive, Influenza is not medically serious, but if he or she perceives that there
would be serious financial consequences as a result of being absent from work for several days, then
he or she may perceive influenza to be a particularly serious condition.
3. Perceived benefits
• It refers to an individual's assessment of the value or efficacy of engaging in a health-promoting
behavior to decrease risk of disease.
• It is a belief or perception about the benefit of being engaged in particular health behavior.
• If an individual believes that a particular action will reduce susceptibility to a health problem or
decrease its seriousness, then he or she is likely to engage in that behavior regardless of objective
facts regarding the effectiveness of the action.
• For example, individuals who believe that wearing sunscreen prevents skin cancer are more likely
to wear sunscreen than individuals who believe that wearing sunscreen will not prevent the
occurrence of skin cancer.
4. Perceived barriers
• Beliefs about the material and psychological costs of taking action.
• To what extent does the individual believe there are barriers preventing him/her from conducting
the behavior?
• Even if an individual perceives a health condition as threatening and believes that a particular action
will effectively reduce the threat, barriers may prevent engagement in the health-promoting
behavior.
• Perceived barriers to taking action include the perceived inconvenience, expense, danger (e.g., side
effects of a medical procedure) and discomfort (e.g., pain, emotional upset) involved in engaging in
the behavior.
• For instance, lack of access to affordable health care and the perception that a flu vaccine shot will
cause significant pain may act as barriers to receiving the flu vaccine.

•Modifying variables
• Individual characteristics, including demographic, psychosocial, and structural variables, can affect
perceptions (i.e., perceived seriousness, susceptibility, benefits, and barriers) of health-related
behaviors.
• Demographic variables include age, sex, race, ethnicity, and education, among others.
• Psychosocial variables include personality, social class, and peer and reference group pressure,
among others.
• Structural variables include knowledge about a given disease and prior contact with the disease,
among other factors.
• Modifying variables affect health-related behaviors indirectly by affecting perceived seriousness,
susceptibility, benefits, and barriers.
•Cues to action
• Factors that activate "readiness to change"
• e.g., a television ad or a reminder from one's physician to get a mammogram
• This model suggests that a cue, or trigger, is necessary for prompting engagement in health-
promoting behaviors.
• Internal cues -Physiological cues (e.g., pain, symptoms)
• External cues - events or information from closers, the media, or health care providers.
 • The intensity of cues needed to prompt action varies between individuals by perceived
susceptibility, seriousness, benefits, and barriers.
•Self-efficacy
• Confidence in one's ability to take action
• Are confident in their ability to successfully perform an action
• Self-efficacy was added to the four components of the health belief model (i.e., perceived
susceptibility, seriousness, benefits, and barriers) in 1988.
• Self-efficacy was added →to better explain individual differences in health behaviors.
• Developers of the model recognized that confidence in one's ability to effect change in outcomes
(i.e., self-efficacy) was a key component of health behavior change.

Limitations

• It does not account for a person's attitudes, beliefs, or other individual determinants that dictate a person's
acceptance of a health behavior.
• It does not take into account behaviors that are habitual and thus may inform the decision- making process
to accept a recommended action (e.g., smoking).
It does not take into account behaviors that are performed for non-health related reasons such as social
acceptability.