Health Belief Model

PHCL 436

Outline

• Introduction.• Model constructs.• Relationship among model constructs.• Limitations. • Applications.

Introduction

• 1950s. Studying why individuals did or did not participate in screening programs for tuberculosis.

• Studies to assess this model provided support to this model.

• Focus on two: Perceived benefits and threats.

HBM Constructs

• Perceived susceptibility

• Perceived severity

• Perceived benefits

• Perceived barriers

• Cues to action

• Self-efficacy

Perceived susceptibility

• The person’s perception of the risk of getting a health condition.

Perceived severity

• Person’s belief about the seriousness of the disease.

Perceived benefits

• Person’s belief about the benefits of this specific action (for example taking

medication).

Perceived barriers

• Related to person’s belief about barriers of taking the action.

Cues to action

• Different methods and strategies used to activate and trigger the person to take action.

Self-efficacy

• How the person confident of ability to take the action to take care of the health condition.

Figure 1. The relationship between the components of the HBM and behavior change

Likelihood of behavior change

Perceived threat of disease

Cues to action

EducationSymptomsMedia

Perceived susceptibility to,

severity of disease

Age, sex, ethnicityPersonality

SocioeconomicsKnowledge

Perceived benefits minus perceived barriers to

behavior change

Likelihood of actionModifying FactorsIndividual Perceptions

Comments

• Research:– Use multiple item for each scale to reduce errors. – Validity and reliability for various setting.

• Limitations: – Not considering emotion. E.g. Fear.

Example discussion

Application

• Behavioral Factors Predict Adherence to Lipid-Lowering Medications.

• Factors for non-adherence:– The asymptomatic nature of dyslipidemia, – Adverse effects of medications, – Cost related to treatment.

Example

• Perceived susceptibility: The person’s perception of the risk of getting a health condition.

• In patients with dyslipidemia?

Dyslipidemia

• It is the person’s perception of the risk of getting a CAD event.

• It is usually minimized especially for those patients in their 30s or 40s as they think getting CAD event is unlikely.

Example

• Perceived severity: Person’s belief about the seriousness of hyperlipdemia.

• In dyslipidemia?

Dyslipidemia

• It is asymptomatic disease, patients may not consider it as a serious condition.

• Except for patients who already developed heart attack.

Example

• Perceived benefits: Person’s belief about the benefits of this specific action (for example taking medication).

• With lipid-lowering medications?

Dyslipidemia

• With lipid-lowering medications patients may not notice any changes in symptoms or reduction in hospitalization.

• To increase the awareness of benefits of lipid-lowering medications:– Feedback to patient about progress of treatment

and changes in lipid levels.

Example

• Perceived barriers: Related to person’s belief about barriers of taking the action.

• Barriers in dysplipidemia?

Dyslipidemia

• Barriers of using lipid-lowering medications include adverse effects, financial, complex regimen, and other patients concerns.

Example

• Cues to action: Different methods and strategies used to activate and trigger the person to take action.

• Triggers to adhere to lipid-lowering medications?

Triggers

• Heart attack• Good communication and feedback on lipid

levels • Reminders

Example

• Self-efficacy: How the person confident of ability to take the action to take care of the health condition.

• In hyperlipidemia it is the person’s confident of ability to take their lipid-lowering medications as prescribed.

Quiz