Health belief model

subject: advance nursing practice

Moderator: Presented by:

Dr. Mona Liza Shailja sharma
Lecturer Msc. Nursing 1st year
NINE, PGIMER, Nine, pgimer,
Chandigarh chandigarh
 INTRODUCTION
• HBM is a good model for addressing problem
behaviors that evoke health concerns. It has been
adapted to explore a variety of long and short
term health behaviors, including sexual risk
behaviors and the transmission of HIV/AIDS.
• It attempted to explain and predict a given health
related behavior from certain patterns of beliefs
about the recommended health behavior and the
health problem that the behavior was intended
to prevent or control.
 HISTORY AND ORIENTATION
• The Health Belief Model (HBM) is one of the first
theories of health behavior.
• It was developed in the 1950s by a group of U.S.
Public Health Service social psychologists i.e.
Hochbaum, Rosenstock and kegels who wanted
to explain why so few people were participating
in programs to prevent and detect disease. .The
model was developed in response to the failure
of a free tuberculosis health screening program.
 Contd...
• The model postulates that the following four
conditions both explain and predict a health
related behaviour:

Belief in susceptibility Potential seriousness

Perceived or anticipated
Cues to action
benefits and costs
 Contd....
• HBM is a popular model applied in nursing, especially
in issues focusing on patient compliance and
preventive health care practices.
• The model postulates that health-seeking behaviour is
influenced by a person’s perception of a threat posed
by a health problem and the value associated with
actions aimed at reducing the threat.
• HBM addresses the relationship between a person’s
beliefs and behaviors. It provides a way to
understanding and predicting how clients will behave
in relation to their health and how they will comply
with health care therapies.
 CORE ASSUMPTIONS AND
STATEMENTS
The HBM is based on the understanding that a person will
take a health related action(vaccination) if that person:
• Feels that a negative health condition (i.e. communicable
disease) can be avoided
• Has a positive expectation that by taking a recommended
action, he/she will avoid a negative health condition (i.e.
vaccination will be effective at preventing communicable
disease.)
• Believes that he/she can successfully take a
recommended health action ((i.e. vaccination is safe to
be used and has an acceptable level of risk).
•
 COMPONENTS OF HBM MODEL

Individual’s perception of susceptibility

of an illness

Individual’s perception of seriousness of

illness

Likelihood that the person will take

preventive action.
 THE MAJOR CONCEPTS OF HBM
MODEL
There are six major concepts in HBM:
1. Perceived Susceptibility
2. Perceived severity
3. Perceived benefits
4. Perceived Barriers
5. Cues to action
6. Self -efficacy
SNo. CONCEPT DEFINITION APPLICATION

1 PERCEIVED One’s belief of the chances •Define population(s) at

SUSCEPTIBILITY of getting a condition risk and their risk levels
•Personalize risk based on
a person’s trait or
behaviors.
•Heighten perceived
susceptibility if too low

2 PERCIEVED SEVERITY One’s belief of how serious Specify and describe

a condition and its consequences of the risk
consequences are and the condition

3 PERCIEVED BENEFITS One’s belief in the efficacy •Define action to take –

of the advised action to how, where , when
reduce risk or seriousness •Clarify the positive effect
of impact. to be expected.
•Describe evidence of
effectiveness
 SNo. Concepts Definition Application

4 PERCIEVED One’s belief in the  Identify and reduce

BARRIERS tangible and the barriers through
psychological costs of reassurance,
the advised behavior. incentives, and
assistance.

5 CUES TO ACTION Strategies to activate  Provide how to

“readiness”. information
 Promote awareness
 Provide reminders

6 SELF EFFICACY Confidence in one’s  Provide training ,

ability to take action guidance and
positive
reinforcement.
 PURPOSE OF THE MODEL :

Method to explain and predict

preventive health behavior.
CONCEPTUAL MODEL
 INDIVIDUAL PERCEPTIONS
• Perceived susceptibility: It is one’s opinion of
chances of getting a condition. It makes the
individual to feel at high risk to a disease like
family history of cardiac disorder, diabetes.
• Perceived seriousness: It is one’s opinion of how
serious a condition and its consequences are. It
makes a individual to think that whether illness
cause death or has any other serious
consequences. For e.g. ,concern about the spread
of AIDS reflects the people’s perception of
seriousness of disease.
 INDIVIDUAL PERCEPTIONS
• Perceived threat: Perceived susceptibility and perceived
seriousness together determine the threat of an illness to a
specific individual. For e.g., a drug addict or a homosexual has
more perceived threat of AIDS than a normal person because
the susceptibility is combined with the seriousness.
• Self Efficacy: Self Efficacy is another related concept,
introduced by albert bandura. Although someone may believe
that how some future events turn out is under his control, he
may or may not believe that he is capable of behaving in a
way that will produce a desired result. For e.g., an athlete may
believe that training 8 hours a day would result in marked
improvement in ability ( an internal locus of control
orientation) but not believer that he or she is capable of
training that hard ( a low sense of self efficacy).
 MODIFYING FACTORS
• Demographic variables. Demographic
variables include age, sex, race, and ethnicity.
An infant, for example, does not perceive the
importance of a healthy diet; an adolescent
may perceive peer approval as more
important than family approval and as a
consequence may participate in hazardous
activities or adopt unhealthy eating and
sleeping patterns.
 MODIFYING FACTORS
• Sociopsychological variables. Social pressure or
influence from peers or other reference groups
(e.g., self-help or vocational groups) may
encourage preventive health behaviors even
when individual motivation is low. Expectations
of others may motivate people, for example, not
to drive an automobile after drinking alcohol
• Structural variables. Knowledge about the target
disease and prior contact with it are structural
variables that are presumed to influence
preventive behavior.
 MODIFYING FACTORS
• Cues to action. Cues can be either internal or
external. Internal cues include feelings of
fatigue, uncomfortable symptoms, or thoughts
about the condition of an ill person who is
close.
 LIKELIHOOD OF ACTION
• The likelihood of a person taking recommended
preventive health action depends on the perceived
benefits of the action minus the perceived barriers to
the action:
• Perceived benefits of the action. Examples include that
in order to prevent lung cancer one refrains from
smoking, and to maintain weight, one eats nutritious
foods and avoids snacking.
• Perceived barriers to action. Examples include cost,
inconvenience, unpleasantness, and lifestyle changes.
• Self efficacy
 SCOPES AND APPLICATION
The HBM has been applied to a broad range of health
behaviors and subject populations. Three broad areas
can be indentified:
• Preventive health behaviors , which include health
promoting (e.g. diet, exercise) and health risk (e.g.
smoking) behaviors as well as vaccination and
contraceptive practices.
• Sick role behaviors, which refer to compliance with
recommended medical regimens, usually following
professional diagnosis of illness.
• Clinic use, which includes physician visits for a variety
of reasons.
 CRITICISMS OF HBM
• Is health behaviour that rational? Its emphasis on
the individual (HBM ignores social and economic
factors)
• ·The absence of a role for emotional factors such
as fear and denial.
• Alternative factors may predict health behavior,
such as outcome expectancy (whether the person
feels they will be healthier as a result of their
behavior) and self-efficacy (the person’s belief in
their ability to carry out preventative behavior) .
 LIMITATIONS OF HBM
• It does not account for a person's attitudes, beliefs, or other
individual determinants that dictate a person's acceptance of a
health behaviour.
• It does not take into account behaviours 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 behaviours that are performed for
non-health related reasons such as social acceptability.
• It does not account for environmental or economic factors that may
prohibit or promote the recommended action.
• It assumes that everyone has access to equal amounts of
information on the illness or disease.
• It assumes that cues to action are widely prevalent in encouraging
people to act and that "health" actions are the main goal in the
decision-making process.
Global Journal of Health Science; Vol. 8, No. 2; 2016 ISSN 1916-9736 E-ISSN 1916-9744 Published
by Canadian Center of Science and Education

A month after the intervention, the mean score of

knowledge ,perceived severity, perceived benefits in
each group were significantly different.
 REFERANCES:
• Brar Kaur Navdeep, Rawat H.C.. Health Belief
Models. Textbook Of Advanced Nursing Practice. First
Edition. Jaypee Publications; 2015. P701-704.
• Raj Bhaskara Elakkuvana D. Health Belief Model:
Explaining Health Behavior. Nursing Theories: A
Practical View. First Edition. Jaypee Publications;
2011. P 235-238.
• Kozier Barbra, Erb LG, Berman Andrey, Synder J
Shirleen, Franden Geralyn. Health Belief Model.
Fundamentals Of Nursing. Julie Levin Alexender
Publications.; 2016. P 268-270.