Health Belief Model

Use of a condom may hinge on your perceived risk of STDs

Couple kissing at night
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What Is the Health Belief Model?

The Health Belief Model (HBM) is a tool that scientists use to try and predict health behaviors. It was originally developed in the 1950s, and updated in the 1980s. The model is based on the theory that a person's willingness to change their health behaviors is primarily due to the following factors:

  • Perceived Susceptibility
  • People will not change their health behaviors unless they believe that they are at risk.
  • Example: Those who does not think that they are at risk of acquiring HIV from unprotected intercourse are unlikely to use a condom. Young people who don't think they're at risk of lung cancer are unlikely to stop smoking.
  • Perceived Severity
  • The probability that a person will change his/her health behaviors to avoid a consequence depends on how serious he or she considers the consequence to be.
  • Example: If you are young and in love, you are unlikely to avoid kissing your sweetheart on the mouth just because he has the sniffles, and you might get his cold. On the other hand, you probably would stop kissing if it might give you Ebola. Similarly, people are less likely to consider condoms when they think STDs are a minor inconvenience. That's why talk about safe sex increased during the AIDS epidemic. The perceived severity increased enormously. 
  • Perceived Benefits
  • It's difficult to convince people to change a behavior if there isn't something in it for them. People don't want to give up something they enjoy if they don't also get something in return.
  • Example: Your father probably won't stop smoking if he doesn't think that doing so will improve his life in some way. A couple might not choose to practice safe sex, if they don't see how it could make their sex life better. 
  • Perceived Barriers
  • One of the major reasons people don't change their health behaviors is that they think that doing so is going to be hard. Sometimes it's not just a matter of physical difficulty, but social difficulty as well. Changing your health behaviors can cost effort, money, and time.
  • Example: If everyone from your office goes out drinking on Fridays, it may be very difficult to cut down on your alcohol intake. If you think that condoms are a sign of distrust in a relationship, you may be hesitant to bring them up. 

One of the best things about the Health Belief Model is how realistically it frames people's behaviors. It recognizes the fact that sometimes wanting to change a health behavior isn't enough to actually make someone do it. Therefore, it incorporates two more elements into its estimations about what it actually takes to get an individual to make the leap. These two elements are cues to action and self efficacy.

Cues to action are external events that prompt a desire to make a health change. They can be anything from a blood pressure van being present at a health fair, to seeing a condom poster on a train, to having a relative die of cancer. A cue to action is something that helps move someone from wanting to make a health change to actually making the change.

In my mind, however, the most interesting part of the Health Belief Model is the concept of self efficacy. This is an element which wasn't added to the model until 1988. Self efficacy looks at a person's belief in his/her ability to make a health related change. It may seem trivial, but faith in your ability to do something has an enormous impact on your actual ability to do it. Thinking that you will fail will almost make certain that you do. In fact, in recent years, self efficacy has been found to be one of the most important factors in an individual's ability to successfully negotiate condom use.

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