Health Belief Model

Posted: February 16, 2017

Abstract

Objective:  This paper is on discussion of the different perceptions of Health Belief Model, which includes perceived susceptibility, severity, benefits and perceived barriers.  The history of the model, its strength and weakness of the model are also discussed.  The paper also address the applicability of the model by evaluating a paper on study conducted in Cameroon.  The study used Health Belief Model framework and thus it was useful for evaluation.

Key words:  Health Belief Model, HIV/AIDS, perceived susceptibility, perceived severity, perceived benefits and perceived.

Introduction

The term Health Belief Model (HBM) refers to the psychological model that explains and predicts the health behaviour of people by focusing on the beliefs and attitudes the people have. It was developed in 1950’s and based on four perceptions: perceived susceptibility, severity, benefits and the last one being perceived barriers.  The model has its strengths and weaknesses which this paper addresses. 

History

The concept of HBM developed by Hochbaum in 1950’s is that the health behaviour of an individual is determined by his belief or perception as regards a disease and strategy in place to decrease its occurrence. 1,2 It was developed to respond to the failure of TB screening was offered free of charge.  Very few people showed up, prompting a research to identify the cause. He identified perceived risk, and perceived benefits of actions are important factors in motivating.

In 1988, the concept of efficacy and cues of action were added.3,4 The model has its bases on the conceptual framework; it is useful in understanding reasons behind non-compliance with recommended health conditions.   The four main perception of the model are; perceived seriousness also referred to as perceived severity, perceived benefits, perceived susceptibility, perceived perceptions and perceived barriers.  The model has expanded recently to include self-efficacy and cues to action.

Perceived Severity/Seriousness

This concept refers to the belief one has on the severity of a health problem or condition and it probable outcome.  When an individual realizes that he will be negatively affected physically and socially when he contact the state, then that person takes actions aimed at avoiding the negative consequences.5 One will not engage in undesirable health behaviour if the individual belief that there is potential seriousness or illness arising from the engagement.

Perceived Susceptibility

Susceptibility is the belief an individual has towards contracting a disease and how seriously he views the threat of illness.6 When a person believes that a health problem is relevant to him and that he is venerable, he will take necessary steps to prevent perceived health problem.7 Health education and acquisition of knowledge concerning a disease is a tool for changing an individual perception.  The experience, in turn, reduces the risk of contracting the disease.  When the perceived risk is significant, there is less likelihood of engaging in the behaviour.  When a person believe that the risk of susceptibility is low, he will participate in unhealthy practice.1

Perceived Benefits

This concept refers to an opinion an individual develops on the value of new behaviour on decreasing the likelihood of developing the new disease.1The person has to believe that the action taken is useful in reduction, avoiding or preventing an occurrence of health problem.  The belief gives one confidence to take bold decision and measures because of expectation of positive outcome.  People adopt healthier behaviour when there is believe that new behaviour reduces chances of getting a disease.

Perceived Barriers

The perceived barrier is the evaluation of obstacles preventing one from implementing the new act, the belief in tangible and the psychological costs.1,2 The barriers include phobic reaction individual has towards a new behaviour, psychological barrier including trauma and stress on what friends and relatives will say.  The cost of adopting to the new behaviour, the duration to be taken to take fully, the incontinences the behaviour will have towards a person life and the complexity of trying to change and adopt the new behaviour.  Making bold and informed decision enables a person deal with the barriers and takes corrective actions.

Self-efficacy

Apart from the four top perceptions other additional perception were introduced.  They include self-efficacy and cues to action.  A person will not try new things if his belief is that he is not capable of doing it even though they believe it to be useful.  The concept of self-efficacy is directly transferred from the works of Bandura.2 An individual should be confident and feel that he is capable of making necessary corrections that motivates and sustains the action.  He should always belief on his own ability to make decisions and respond to challenges.

Cues to Actions

Cues in action refer to the people, events or other things that influence a person to change the way he behaves.  The facts motivate a person to take an action.  The student concerned about his life and had knowledge about the side effect of contracting HIV/AIDs is likely to use condoms as a precautionary measure.  Knowledge on how to deals with barriers is paramount in decision-making upon the realization that one can do so.2

Strength and Shortcoming of the Model

The strength of the model is acknowledging that one’s health choice is on the rational basis, conditional and personal preferences.  The behaviour one may make or ruin the health conditions.  The model is relevant as it focuses on an individual.  Therefore an individual can get attention especially from nurses who focuses on patient compliance and the preventive health care.  When a person realizes the potential risk arising from an individual behaviour, say unprotected sex; the person will take an initiative to protect himself against risks such as HIV/AID and STIs.  The person understands there is a presence of barriers to achieving his behavioural change, and the individual prepares on how to deal with it.  The seriousness of the outcome of behaviour pulls a person from engaging in unhealthy behaviours.

The shortcomings of the model are that it doesn’t specify how the constructs interact, thereby making it difficult to carry comparison.  It is also difficult to measure the level of behavioural change, thus making cues to action trying to use as a tool to assess health-related behaviour.  Advertisements, training and distribution of leaflets as means of educating the people can’t be used to measure understanding or knowledge of the target groups.  The model emphasis only on the individual it ignores other important factors such as social, political and economic factors which play a role in one's way of life.  The model focuses only on health-related behaviour by focusing on belief but fails to take account of other influencing factors like religion, habit and independent environmental factors.  The rationality of the method cannot authoritatively be measured.8

Application of Health Belief Model (HBM) in HIV in Cameroon

A study conducted in Mbonge, Cameroon used Health Belief Model as a framework for exploring factors associated with the consistent condom use among the senior secondary school female students. The study concentrated on HBM construct and HIV/AIDS prevention.  It covered the six construct constructs of HBM.  The assumption of the survey was that once people were aware of HIV/AIDS and its modes of transmission, then they will change their behaviour.  It divided the model into three parts; individual perception about health, the modifying factors, and benefits accrued on taking preventive measures.  The observation was that different understanding on HIV/AIDS changes due to the acquisition of new knowledge. Modifying factors under consideration was demographic and structural variables.  There was the observation that one’s perception of benefits, severity and susceptibility could be affected by socio-demographic factors.  The variables of the study identified are the student’s perceived benefit of the practicing safe using male condoms.  The concept of desire to avoid illness and belief that a particular health action is available to an individual is put into consideration.

Under the study, it was observed that the desire would be to avoid HIV/AIDS while particular health action available is consistent us of male condoms.  People should perceive the disease as severe and infectious before they adopt protective measures, they should understand that they are susceptible to the virus and use a condom for protection.  The belief in the effectiveness of condoms in the prevention of the virus should be in positive correlation with their consistent use.  The cause of action should be acceptance of health care and engage in positive health activities and develop a belief of having ability respond to stressful situations when they face a person.

Conclusion

The Health Belief Model as advanced over years.  The model has four perceptions.  The perceived referred to as severity, perceived benefits, perceived susceptibility, perceived perceptions and perceived barriers.  The model has its set of setbacks and benefits. The model has been used in Cameroon to study the use of condoms among secondary school students and HIV/AIDS.

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