Chapter 2: Managing Stress
The Health Belief Model
The health belief model (HBM) is a psychological health behavior change model developed to explain and predict health-related behaviors, particularly in regard to the uptake of health services. The health belief model was developed in the 1950s by social psychologists at the U.S. Public Health Service and remains one of the best known and most widely used theories in health behavior research.
The health belief model suggests that people’s beliefs about health problems, perceived benefits of action and barriers to action, and self-efficacy explain engagement (or lack of engagement) in health-promoting behavior. A stimulus, or cue to action, must also be present in order to trigger the health-promoting behavior.
History
One of the first theories of health behavior, the health belief model was developed in the 1950s by social psychologists Irwin M. Rosenstock, Godfrey M. Hochbaum, S. Stephen Kegeles, and Howard Leventhal at the U.S. Public Health Service to better understand the widespread failure of screening programs for tuberculosis. The health belief model has been applied to predict a wide variety of health-related behaviors such as being screened for the early detection of asymptomatic diseases and receiving immunizations. More recently, the model has been applied to understand patients’ responses to symptoms of disease,[2] compliance with medical regimens, lifestyle behaviors (e.g., sexual risk behaviors), and behaviors related to chronic illnesses, which may require long-term behavior maintenance in addition to initial behavior change.
Amendments to the model were made as late as 1988 to incorporate emerging evidence within the field of psychology about the role of self-efficacy in decision-making and behavior.
Theoretical Constructs
The following constructs of the health belief model are proposed to vary between individuals and predict engagement in health-related behaviors (e.g., getting vaccinated, getting screened for asymptomatic diseases, exercising).
(base score for smoking behavior)
| Health belief model chart (smoking as an example) | |||||||
|---|---|---|---|---|---|---|---|
| Modifying Variables
(age, gender, race, economy, characteristics) |
Perceived Severity
+ Perceived Susceptibility |
+ | perceived benefit
– perceived barriers |
+ | Cues to Action | = | taking action (or not) |
| (base score for this person’s health) | (base score as to the belief that smoking will harm one’s health) |
Perceived Severity
Perceived severity refers to the subjective assessment of the severity of a health problem and its potential consequences. The health belief model proposes that 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). Perceived seriousness encompasses beliefs about the disease itself (e.g., whether it is life-threatening or may cause disability or pain) as well as b