The Health Belief Model helps explain why individual patients may accept or reject preventative health services or adopt healthy behaviors. Social psychologists originally developed the Health Belief Model to predict the likelihood of a person taking recommended preventative health action and to understand a person’s motivation and decision-making about seeking health services. The Health Belief Model proposes that people will respond best to messages about health promotion or disease prevention when the following four conditions for change exist:
- The person believes that he or she is at risk of developing a specific condition.
- The person believes that the risk is serious and the consequences of developing the condition are undesirable.
- The person believes that the risk will be reduced by a specific behavior change.
- The person believes that barriers to the behavior change can be overcome and managed.
The first condition in the Health Belief Model is perceived threat. If the person does not see a health care behavior as risky or threatening, there is no stimulus to act. For example, a 59 year old woman who sunbathes every day who doesn’t believe that she is at risk of skin cancer will continue to sun bathe. There are two types of perceived threats: perceived susceptibility and perceived severity. Susceptibility refers to how much risk a person perceives he or she has; severity refers to how serious the consequences might be. To effectively change health behaviors, the individual must usually believe in both susceptibility and severity. This is one reason that many people “get religion” after they have been diagnosed with cancer, heart disease, or diabetes. Because both susceptibly and severity are a clear and present danger, people who have previously resisted or put off behavior change finally give up smoking, stop drinking, lose weight, or start an exercise program. Individuals must also have the expectation that the new behavior will be beneficial; they must feel that barriers to change do not outweigh the benefits and that they can realistically accomplish the needed changes in behavior. Unfortunately, for many desirable health behaviors, the barriers are immediate and the benefits are long-range. For example, it’s difficult to pass up eating a piece of chocolate cake with the hope that you will not have heart disease or cancer in the future. From this perspective, it is not hard to see why it is so difficult to get patients to change behaviors.
Knowing what aspect of the Health Belief Model patients accept or reject can help you design appropriate interventions. For example, if a patient is unaware of his or her risk factors for one or more diseases, you can direct teaching toward informing the patient about personal risk factors. If the patient is aware of the risk, but feels that the behavior change is overwhelming or unachievable, you can focus your teaching efforts on helping the patient overcome the perceived barriers.