Dengue Bulletin � Vol 29, 2005 217

The Use of the Health Belief Model inDengue Health Education

Jeffrey L. Lennon!!!!!

Foundation University, College of Education, Dumaguete City, Philippinesand

International Technical Assistance Group,Seattle, WA, U.S.A.

!!!!!jeffchona2@yahoo.com

Short Note

Dengue fever/dengue haemorrhagic fever is agrowing pandemic health problem[1]. Sourcereduction of Aedes mosquito breeding sites iscritical for its control. These larval mosquito-breeding sites include many human-madeitems (trash) such as cans and tyres[2]. Thesource reduction of these mosquito breedingsites are related to human behaviour[3].

Dengue fever prevention and control canbe explained through health behaviour theory.Health behaviour theory may be used as aframework to design a health education-healthbehavioural change intervention, a means oftesting or evaluating whether a programmeworks, and also used to create educationalmaterials and health messages[4]. Thus, dengueprevention and control may utilize a healthbehaviour theory for its programme. The healthbelief model (HBM)[5], a well-establishedtheoretical approach, may be employed toaddress the problem of dengue control.

The principal constructs of the HBM are:perceived susceptibility, perceived severity,perceived benefits, cues-to-action, and self-efficacy. Perceived susceptibility refers to aperson�s belief in the likelihood of contractinga disease, while perceived severity refers to aperson�s belief that contracting the disease mayresult in harsh health consequences. Taken

together, these two constructs form theperceived threat to health. The perceivedbenefits involve the beliefs of individuals inthe value of adhering to health-relatedmeasures to prevent or reduce the illness ordisease, whereas perceived barriers refer tothe belief in the costs (psychological or material)that limit a person to carry out the necessaryhealth-related measures. There needs to begreater perceived benefits than perceived costsin order for a person to carry out the proposedhealth-related measures to lessen the diseaseimpact[5].

The construct of self-efficacy refers toone�s confidence to perform the necessaryhealth-related action. This is usually applied byperforming step-by-step or incremental goals.This social learning/social cognitive theoryconstruct was proposed by Bandura[6]. It waslater included in the HBM[5]. Applied to denguecontrol, it could refer to a step-by-step approachto gain confidence to perform a weekly denguecontrol-related clean-up.

The cues-to-action construct refers toanything that may heighten awareness or triggerinterest in performing the necessary health-related activity to prevent, control, treat orelevate the health problem. The cue could takethe form of a message on a poster, calendar,

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The Use of the Health Belief Model in Dengue Health Education

placards, vehicles or a message reminder onthe radio. Health education strategies throughthe media may be powerful means to presentcues[5].

Health messages based on HBM constructsmay be formatted in the style of a one line orshort public service announcement (PSA) or asa dialogue public service announcementespecially for radio use. The FoundationUniversity Radio Station, together with theFoundation University College of Education,conducted a dengue communication campaignduring September�October 2003 inDumaguete, Philippines, a dengue endemiccity. The programme�s daily PSAs were basedon the HBM. There were 24 rotating messagesin the campaign�s programme. These includedshort message PSAs and also dialogue PSAs.Examples of dengue health issues related totheir corresponding HBM constructs, as wellas health communication messages to address

these health issues based on the HBMconstructs used in the university �s radiocampaign are presented in the Table.

This report suggests that healthcommunication messages designed throughHBM constructs may be used to communicateawareness about dengue and its control.Furthermore, these HBM constructs may beapplied as cues-to-action in one�s culturalcontext to address dengue fever control issues.

Acknowledgments

Thanks to the Foundation University RadioStation and the College of Education for makingthe radio broadcasts possible. Thanks also tothe Foundation University for permission toreproduce the messages. The support of theInternational Technical Assistance Group is alsogratefully acknowledged.

Table: Dengue messages based on HBM constructs

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References

[1] World Health Organization. Internationalconference on dengue/dengue haemorrhagicfever. Chiang Mai declaration on dengue/denguehaemorrhagic fever (Strengthening efforts tocontrol dengue in the new millennium). DengueBulletin. 2000; 24: 129-130.

[2] World Health Organization. Dengue: policy,strategy and objectives. http://www.who.int/ctd/dengue/strategies.htm .

[3] World Health Organization. Strengtheningimplementation of the global strategy for dengue

fever/dengue haemorrhagic fever prevention andcontrol. Dengue Bulletin. 1999; 23: 118-119.

[4] Glanz K. Lewis F.M. and Rimer B.K. Linking theoryresearch and practice. In: K. Glanz, F.M. Lewisand B.K. Rimer Eds. Health behavior and healtheducation: theory, research and practice. 2nd ed.San Francisco: Jossey-Bass, 1997: pp. 19-40.

[5] Strecher V.J. and Rosentock I.M. The health beliefmodel. In: K. Glanz, F.M. Lewis, and B.K. Rimer.Eds. Health behavior and health education: theory,research and practice. 2nd Ed. San Francisco: Jossey-Bass, 1997: pp. 41-59.

[6] Bandura A. Self efficacy: towards a unifying theory ofbehavior change. Psych Rev. 1977; 84(2): 191-215.