HEALTH BELIEF MODEL

1. HEALTH BELIEF MODEL An Luu

2. The Health Belief Model (HBM) was developed in the 1950s and has been practiced because it is logical, well articulated and simple.

3. Constructs of HBM • Perceived susceptibility: refers to belief about the likelihood of getting a disease or condition • Perceived the severity: feeling about the seriousness of contracting an illness or if leaving it untreated • Level of perceived threat: a compound of the two above elementary constructs, influences in the likelihood of the action– an expectancy-value formulation • Cues to the action: events, symptoms experienced by the person or reminders provided by a credible source • Modifying factors: age, race, gender, knowledge • Expected net gain (perceived benefits): benefits of adopting the health protective behavior, it is also the result expectancy-value formation.

4. Representation of HBM Expected consequences Value of consequences Level of perceived threat Modifying factors Expected net benefit Perceive the severity Likelihood to take action Perceive susceptibility Cues to action

5. Addition • Self efficacy was introduced to the HBM in 1977 and we will learn in Chapter 8. • People will not try a new behavior unless they are confident that they can perform the behavior.

6. THE THEORY OF TRIADIC INFLUENCE Levels of Causation Ultimate CULTURAL SOCIAL BIOLOGY/ Causes ENVIRONMENT SITUATION PERSONALITY 1 2 3 4 5 6 a f Social/ Personal Nexus c d e b Sense of Information/ Interpersonal Others’ Social Interactions w/ Self/Control Opportunities Bonding Beh & Atts Competence Social Instit’s Distal Influences 7 8 9 10 11 12 g r p i q h k n m l j o Expectancies & Evaluations Self Skills: Motivation Perceived Values/ Knowledge/ Determination Social+General to Comply Norms Evaluations Expectancies 13 14 15 16 17 18 s x ATTITUDES SOCIAL SELF-EFFICACY u w v t Affect and Cognitions TOWARD THE NORMATIVE BEHAVIORAL BEHAVIOR BELIEFS CONTROL Proximal 19 20 21 Predictors Decisions A G B H C I D E F 22 K Experiences 23 Related Behaviors J Intrapersonal Stream Social/Normative Stream Cultural/Attitudinal Stream Biological/Nature Nurture/Cultural DECISIONS/INTENTIONS Trial Behavior EXPERIENCES: Expectancies -- Social Reinforcements -- Psychological/Physiological 6

7. Example 1: getting flu shot • Perceive the severity: how sick I will be if I get flu? • Perceive susceptibility: how likely I would get flu? • Cues to the actions: on TVs, radio These constructs directly contribute to level of perceived threat

8. Example 1: getting flu shot • Modifying factors: time, financial cost… • Expected net benefits: • the benefits of getting flu shot (not likely to get flu, no days off from work, affect quality of other chores). • The modifying factorsinfluence the perception of threat and the expected net benefits, and these two constructs both directly influence the behavior change

9. Example 2: screening for HTN • Perceive the severity: complications (stroke, MI…) • Perceive susceptibility: prevalence of raised BP in people >25yo was about 40% (2008-WHO) • Cues to the actions: on TV, radio, posters at clinics • Modifying factors: age, lifestyle, time, financial cost… • Expected net benefits: maintain good health quality, prevent from getting the complications and disabilities.

10. Thank you!