1. Health Belief Model PHCL 436

2. Outline Introduction. Model constructs. Relationship among model constructs. Limitations. Applications.

3. Introduction 1950s. Studying why individuals did or did not participate in screening programs for tuberculosis. Studies to assess this model provided support to this model. Focus on two: Perceived benefits and threats.

4. HBM Constructs Perceived susceptibility Perceived severity Perceived benefits Perceived barriers Cues to action Self-efficacy

5. Perceived susceptibility The person’s perception of the risk of getting a health condition.

6. Perceived severity Person’s belief about the seriousness of the disease.

7. Perceived benefits Person’s belief about the benefits of this specific action (for example taking medication).

8. Perceived barriers Related to person’s belief about barriers of taking the action.

9. Cues to action Different methods and strategies used to activate and trigger the person to take action.

10. Self-efficacy How the person confident of ability to take the action to take care of the health condition.

11. Figure 1. The relationship between the components of the HBM and behavior change Likelihood of behavior change Perceived threat of disease Cues to action  Education  Symptoms  Media Perceived susceptibility to, severity of disease Age, sex, ethnicity Personality Socioeconomics Knowledge Perceived benefits minus perceived barriers to behavior change Likelihood of actionModifying FactorsIndividual Perceptions

12. Comments Research: – Use multiple item for each scale to reduce errors. – Validity and reliability for various setting. Limitations: – Not considering emotion. E.g. Fear.

13. Example discussion

14. Application Behavioral Factors Predict Adherence to Lipid- Lowering Medications. Factors for non-adherence: – The asymptomatic nature of dyslipidemia, – Adverse effects of medications, – Cost related to treatment.

15. Example Perceived susceptibility: The person’s perception of the risk of getting a health condition. In patients with dyslipidemia?

16. Dyslipidemia It is the person’s perception of the risk of getting a CAD event. It is usually minimized especially for those patients in their 30s or 40s as they think getting CAD event is unlikely.

17. Example Perceived severity: Person’s belief about the seriousness of hyperlipdemia. In dyslipidemia?

18. Dyslipidemia It is asymptomatic disease, patients may not consider it as a serious condition. Except for patients who already developed heart attack.

19. Example Perceived benefits: Person’s belief about the benefits of this specific action (for example taking medication). With lipid-lowering medications?

20. Dyslipidemia With lipid-lowering medications patients may not notice any changes in symptoms or reduction in hospitalization. To increase the awareness of benefits of lipid- lowering medications: – Feedback to patient about progress of treatment and changes in lipid levels.

21. Example Perceived barriers: Related to person’s belief about barriers of taking the action. Barriers in dysplipidemia?

22. Dyslipidemia Barriers of using lipid-lowering medications include adverse effects, financial, complex regimen, and other patients concerns.

23. Example Cues to action: Different methods and strategies used to activate and trigger the person to take action. Triggers to adhere to lipid-lowering medications?

24. Triggers Heart attack Good communication and feedback on lipid levels Reminders

25. Example Self-efficacy: How the person confident of ability to take the action to take care of the health condition. In hyperlipidemia it is the person’s confident of ability to take their lipid-lowering medications as prescribed.

26. Quiz