Chapter 5: The Health Belief Model Flashcards
when was the HBM developed?
in the 1950’s by social psychologists in the US public health service to explain widespread failure of people to participate in programs to prevent and detect disease
at the time, researchers and health professionals were concerned because few people were getting screening for tuberculosis when mobile x-ray machines would drive through their neighborhoods
what did social psychologists create in the first half of the twentieth century?
two approaches for explaining behavior: the stimulus response theory and the cognitive theory
stimulus response theory
stimulus response theorists believed that events (termed reinforcements) affect physiological drives that activate behavior. BF Skinner formulated the widely accepted hypothesis that frequency of behavior is determined by its reinforcements
The mere temporal association between a behavior and an immediately following reward was though to be sufficient to increase the probability that the behavior would be repeated
cognitive theory
cognitive theorists believed that reinforcements operated by influencing expectations rather than by influencing behavior directly. mental processes such as thinking, reasoning, hypothesizing, or expecting are critical components of cognitive theories, which are often termed value-expectancy models, because they propose that behavior is a function of expectation, that a particular action will achieve that outcome
what are the key components of the HBM?
perceived susceptibility perceived severity perceived benefits barriers to engaging in a behavior cues to action self-efficacy
overall premise of the HBM is that people are likely to engage in a health behavior if they believe that:
1) they are susceptible to a condition (at risk of disease)
2) the condition could have potentially serious consequences
3) a course of action (behavior) available to them could be of benefit in reducing either their susceptibility to or the severity of the condition
4) there are benefits to taking action
5) their perceived barriers (or costs) are outweighed by the benefits and are not strong enough to prevent actions
perceived susceptibility
belief about the likelihood of getting a disease or condition. for instance, a woman must believe that she is at risk of getting colon cancer before the is willing to take action by getting screened
perceived severity
a belief about the seriousness of contracting an illness or condition or of leaving it untreated, including physical consequences (death, disability, and pain) and social consequences\ (having the ability to work, maintaining relationships with others, or feeling stigmatized)
perceived threat
is the construct formed by the combination of susceptibility and severity. perceived susceptibility should be multiplied by perceived severity to calculated perceived threat; thus if either of these components is zero, the perceived threat would be zero
perceived benefits
are beliefs about positive features or advantages of a recommended action to reduce threat. these benefits might reduce threat of a disease of its consequences. other non-health benefits might be tangible, such as the financial savings related to quitting smoking, or social, such as the satisfaction that may come from doing what a physician recommends or pleasing a family member who has expressed concern about one’s lung cancer risks.
perceived barriers
are defined as possible obstacles to taking action, which can include negative consequences resulting from an action. these perceived obstacles and negative consequences impede action or subsequent engagement in the behavior. obstacles may include inconvenience, cost, or fear of a screening procedure
cues to action
early formulations of the HBM included the concept of cues that can trigger actions. cues can be internal (feeling a symptom that increasing perceived threat) or external (media publicity, a recommendation from a physician during an office visit, receipt of a free sample, or even a friends diagnosis)
cues have not ben well defined - this is a deficit in our understanding of the HBM
what are some other variables affecting the HBM?
an assumption of HBM is that demographic, structural, and psychosocial factor may affect beliefs and indirectly influence health behaviors. for example, sociodemographic factors, such as educational attainment, can indirectly influence behaviors by altering perceptions of susceptibility, severity, benefits and barriers
however, the model does not specify how such racist operate or interact with other constructs. This is a major gap in the HBM
what does the HBM clearly specify?
that health beliefs collectively influence health behaviors, but precise weights, combinations, and relationships, among variables are not delineated. this ambiguity has led to variation in how the HBM has been applied in research
do HBM constructs influence health behaviors?
results from critical reviews meta-analyzing studies using the HBM from 1982 to 2007 have provided substantial empirical support for the HBM constructs, from both prospective and retrospective studies
however, the magnitude of each of the constructs effects is small. perceived barriers are the most powerful single construct, followed by perceived benefits
