Behavioral Science

HEALTH BELIEF MODEL(HBM)

Dr. G.U Ahsan, Ph.D

Origins of HBM

Developed initially in early 1950s by social psychologists Godfrey Hochbaum, Stephen Kegels and Irwin Rosenstock

Developed in an effort to explain failure of health programs in obtaining people’s participation

Origins…

The development of the HBM grew out of real concerns with the limited success of various programs of the Public Health Service in the 1950s. One such early example was the failure of large numbers of eligible adults to participate in tuberculosis (TB) screening programs provided at no charge in mobile X-ray units conveniently located in various neighborhoods.

Origins….

In 1974 HBM model was further extended to analyze:

People’s responses to symptoms

People's behavior a=in response to diagnosed illness

People’s compliance with medical regimens

The HBM theory is a value expectancy theory:

Meaning-

Value: The desire to avoid illness or to get well

Expectancy: The belief that a specific health action available to a person would prevent illness.

Non compliance in health seeking behavior

Patient fail to take medication as prescribed

Do not attend to medical appointments

Skip or stop doing exercise recommended and

Fail to follow recommended diet or other items for life style change.

Components of the HBM

1. Perceived susceptibility:Individual subjective perception to be contracted to an illness

2. Perceived severity:Individual’s feeling concerning the seriousness of contracting an illness or leaving it untreated

3. Perceived benefits:Health behaviors depends upon the beliefs regarding the effectiveness of the various available actions in reducing the disease threat

4. Perceived Barriers:

The potentiality negative aspects of a particular health action.

A kind of non conscious cost-benefit analysis: eg.: it may be expensive, dangerous, unpleasant (painful, difficult, or upsetting), inconvenient, time consuming and so forth.

5. Cues to Action:Any of the following can be the cause of action

Mass media campaigns (awareness)

A reminder letter form doctor

Family illness

Perception of one’s own symptoms

6. Self-Efficacy:

Introduced by Bandura in 1977

For behavioral change people must feel threatened by their current behavior patterns and believe the change will resulting in a valued outcome.

The HBM and Cigarette Smoking Behavior

On the survey of 2000 adult current smokers, ex-smokers and people who had never smoked the result was:

83% of current smokers believed that smoking was harmful to health.

Demographic factor (e.g. age or gender)

Knowledge about health problem

Experience or prior contact with health problem

Mass media campaigns

A reminder letter from doctor or dentist

Family illness

An evaluation of the pros and cons of taking action (preventive)

Likelihood that an individual will take preventive action

An assessment of the perceived thereat of a health problem

Personality factors

Perceptions of one’s own symptoms

Perceived gain/perceived cost (financial cost+time+hazards)

Perception of seriousness of the health problem

Perceived personal susceptibility to the illness (Perceived thereat)

Cues to action

HBM and Its Components

Implications of HBM in the field of Public Health

This model is important to

Address public health concerns like Screening and compliance

Providing as an explanatory and an intervention tool for health behavior

Different Views on Limitations of the Model

Perceived barrier is only the most powerful and influencing component of HBM

Perceived susceptibility and perceived benefits were important and stronger predictors for human behavior

Inconsistent measurement of HBM concepts

Message

It is timely for public health specialists who are attempting to influence health behavior is wise to have utilized Health Belief Model including Self Efficacy in their program planning both in needs assessment and in program strategies.