Main Constructs

The Health Belief Model (HBM) was developed in the 1950's by social psychologists Hochbaum, Rosenstock and others, who were working in the U.S. Public Health Service to explain the failure of people participating in programs to prevent and detect disease. Later, the model was extended by others to study people's behavioral responses to health-related conditions.

Since this time, the Health Belief Model has evolved to address public health concerns and has been applied to a broad range of populations and health behaviors.


CONSTRUCT DEFINITION
Perceived Susceptibility Belief about getting a disease or condition
Perceived Severity Belief about the seriousness of the condition, or leaving it untreated and its consequences
Perceived Benefits Belief about the potential positive aspects of a health action
Perceived Barriers Belief about the potential negative aspects of a particular health action
Cues to Action Factors which trigger action
Self-Efficacy Belief that one can achieve the behavior required to execute the outcome
  • The HBM contains several constructs that are hypothesized to predict why people engage in prevention, screening, and/or controlling health conditions.
    • Personal characteristics, such as age, gender, and ethnicity modify individual perceptions, such as perceived susceptibility, severity, self-efficacy, and benefits & barriers.
    • Perceived susceptibility and severity of a health condition together, have been labeled as "perceived threat."
    • Perceived benefits help reduce perceived threat about a health behavior. Perceived barriers impede health behaviors. Benefits minus barriers support health behavior change.
    • Self-Efficacy influences perceived threat (perceived susceptibility and severity) and perceived benefits minus perceived barriers, which support initiation of health behavior change.
    • Cues in the environment trigger action and act on individual perceptions, such as perceived benefits, and perceived susceptibility.

chapter 3 main constructs

How to Apply the Constructs?

  • Examples:
    • If one is interested in understanding the perceived susceptibility, severity, barriers, and benefits about breast cancer screening/mammography among Vietnamese women over 40 years of age in the U.S, one may consider using the items in the table on the next slide.
    • If one is interested in understanding the self-efficacy and cues to action regarding mammography adherence among women 50 years of age and older, one may consider using the items in the table on the next slide.

CONSTRUCT DEFINITION
Perceived Susceptibility Chances of getting breast cancer are high.
(on a 5 point scale, ranging from "strongly disagree" to "strongly agree")
Perceived Severity My marriage would be endangered if I had breast cancer.
(on a 5 point scale, ranging from "strongly disagree" to "strongly agree")
Perceived Benefits Getting a mammogram has brought me peace of mind.
A mammogram is a routine part of my check up-exam.
(on a 5 point scale, ranging from "strongly disagree" to "strongly agree")
Perceived Barriers Getting a mammogram is too embarrassing.
(on a 5 point scale, ranging from "strongly disagree" to "strongly agree")
Cues to Action Hearing about breast cancer in the news makes me think about getting a mammogram.
(on a 5 point scale, ranging from "strongly disagree" to "strongly agree")
Self-Efficacy How sure are you that you know how to arrange an appointment for a mammogram?
(on a 5 point scale, ranging from "unsure" to "very sure")