1. HEALTH BELIEF MODEL An Luu

2. The Health Belief Model (HBM) was developed in the 1950s and has been practiced because it is logical, well articulated and simple.

3. Constructs of HBM Perceived susceptibility: refers to belief about the likelihood of getting a disease or condition Perceived the severity: feeling about the seriousness of contracting an illness or if leaving it untreated Level of perceived threat: a compound of the two above elementary constructs, influences in the likelihood of the action – an expectancy-value formulation Cues to the action: events, symptoms experienced by the person or reminders provided by a credible source Modifying factors: age, race, gender, knowledge Expected net gain (perceived benefits): benefits of adopting the health protective behavior, it is also the result expectancy-value formation.

4. Representation of HBM Level of perceived threat Perceive susceptibility Perceive the severity Modifying factors Cues to action Expected net benefit Likelihood to take action Expected consequences Value of consequences

5. Addition Self efficacy was introduced to the HBM in 1977 and we will learn in Chapter 8. People will not try a new behavior unless they are confident that they can perform the behavior.

6. 6 DECISIONS/INTENTIONS SOCIAL S ITUATION BIOLOGY/ P ERSONALITY THE THEORY OF TRIADIC INFLUENCE ATTITUDES TOWARD THE BEHAVIOR SOCIAL NORMATIVE BELIEFS Trial Behavior EXPERIENCES: Expectancies -- Social Reinforcements -- Psychological/Physiological SELF-EFFICACY BEHAVIORAL CONTROL Nurture/CulturalBiological/Nature Intrapersonal StreamSocial/Normative StreamCultural/Attitudinal Stream 192021 22 23 Distal Influences Proximal Predictors Levels of Causation Ultimate Causes Social/ Personal Nexus Expectancies & Evaluations Affect and Cognitions Decisions Experiences a b c d e f g h i j k m n o p q r s t u v w x Related Behaviors J K C F I B E H A D G CULTURAL E NVIRONMENT

7. Example 1: getting flu shot Perceive the severity: how sick I will be if I get flu? Perceive susceptibility: how likely I would get flu? Cues to the actions: on TVs, radio These constructs directly contribute to level of perceived threat

8. Modifying factors: time, financial cost… Expected net benefits: – the benefits of getting flu shot (not likely to get flu, no days off from work, affect quality of other chores). – The modifying factors influence the perception of threat and the expected net benefits, and these two constructs both directly influence the behavior change Example 1: getting flu shot

9. Example 2: screening for HTN Perceive the severity: complications (stroke, MI…) Perceive susceptibility: prevalence of raised BP in people >25yo was about 40% (2008-WHO) Cues to the actions: on TV, radio, posters at clinics Modifying factors: age, lifestyle, time, financial cost… Expected net benefits: maintain good health quality, prevent from getting the complications and disabilities.

10. Thank you!