Health Belief Model / Protection Motivation Theory

1. Health Belief Model / Protection Motivation Theory EPHE 348

2. History of the HBM • Developed in the 50’s by the U.S. Public Health Service • Social psychologists were asked to explain why people do not participate in health behaviors (Rosenstock, 1960; 1966) • Developed based on operant and cognitive-behavioral theory

3. Premise of the HBM • Individuals will take action to ward off, to screen for, or to control an ill health condition if: • 1) they regard themselves as susceptible to the condition • 2) they believe it to have potentially serious consequences • 3) they believe a course of action can reduce the susceptibility and seriousness • 4) they believe the costs of the action are outweighed by its benefits

4. Components of the HBM • Perceived Susceptibility • an individual’s perception of her or his risk of contracting a health condition • Perceived Severity • an individual’s perception of the seriousness of a health condition if left untreated • Note: the combination of these is the perceived threat of the health condition (emotive response is fear)

5. Components of the HBM • Perceived Benefits • the perceived effectiveness of taking action to improve a health condition • Perceived Barriers • the perceived impediments to taking action to improve a health condition

6. Components of the HBM • Cues to Action • Body or environmental events that trigger the HBM

7. Health Belief Model

8. Additional Components? • Self-Efficacy • confidence to continue the healthy behavior and overcome temptations • Now an additional component of the HBM

9. Protection Motivation Theory(Rogers, 1984) • Extension and re-working of HBM • Intention to protect oneself is the proximal determinant of health behavior

10. Protection Motivation Theory • Intention is dependent on four components: • 1) perceived susceptibility • 2) perceived severity • 3) Self-efficacy • 4) Response efficacy (benefits versus barriers) • Susceptibility and severity are considered “perceived threat” • Response efficacy and self-efficacy are considered “coping efficacy”

11. Protection Motivation Theory

12. Where Do We Intervene? • Educate about threat (vulnerability, susceptibility) • Fear appraisals • Educate about coping (response efficacy, self-efficacy) • Health education

13. Evaluating the HBM/PMT • APPLICABILITY TO PRACTICE (IS IT USEFUL?) • Coping efficacy is the most important component • Self-efficacy (and perceived barriers) is the most influential component for health behavior • Perceived severity is the weakest component • Health behaviors are long-term? • Perceived vulnerability often influences intentions but not behavior

14. Evaluating the HBM/PMT • COMPREHENSIVE (Does it explain behavior completely?) • No • What about other motives for behavior other than health? These motives appear untapped for explaining behavior.

15. Application Exercise • Please choose a health behavior and population • Assume you are an advertising specialist contracted to develop a persuasive communication (poster, news advertisement etc.) to improve the health behavior for the population • Create a message that includes severity, susceptibility, response efficacy, and self-efficacy for the target population