Using theory as a foundation for program planning and development is consistent with the current emphasis on

using evidence-based interventions in public health, behavioral medicine, and medicine. Theory provides a
road map for studying problems, developing appropriate interventions, and evaluating their successes. I choose
to discuss the Health Belief Model.
The Health Belief Model
The Health Belief Model HBM! was one of the first theories of health behavior, and remains one of
the most widely recogni"ed in the field. It was developed in the #$%&s by a group of U.'. (ublic
Health 'ervice social psychologists who wanted to e)plain why so few people were participating in
programs to prevent and detect disease. *or e)ample, the (ublic Health 'ervice was sending mobile
+-ray units out to neighborhoods to offer free chest +-rays screening for tuberculosis!. ,espite the
fact that this service was offered without charge in a variety of convenient locations, the program was
of limited success. The -uestion was, ./hy01
To find an answer, social psychologists e)amined what was encouraging or discouraging people from
participating in the programs. They theori"ed that people2s beliefs about whether or not they were
susceptible to disease, and their perceptions of the benefits of trying to avoid it, influenced their
readiness to act.
In ensuing years, researchers expanded upon this theory, eventually concluding that six main
constructs influence peoples decisions about whether to take action to prevent, screen for, and
control illness. They argued that people are ready to act if they:
Believe they are susceptible to the condition perceived susceptibility!
Believe the condition has serious conse"uences perceived severity!
Believe taking action would reduce their susceptibility to the condition or its severity
perceived benefits!
Believe costs of taking action perceived barriers! are outweighed by the benefits
#re exposed to factors that prompt action e.g., a television ad or a reminder from ones
physician to get a mammogram! cue to action!
#re confident in their ability to successfully perform an action self-efficacy!
'ince health motivation is the central focus of the HBM is a good fit for addressing problem behaviors that
evo3e health concerns e.g., high-ris3 se)ual behavior and the possibility of contracting HI4!. Together, the
si) constructs of the HBM provide a useful framewor3 for designing both short-term and long-term behavior
change strategies. /hen applying the HBM to planning health programs, practitioners should ground their
efforts in an understanding of how susceptible the target population feels to the health problem, whether they
believe it is serious, and whether they believe action can reduce the threat at an acceptable cost. 5ttempting to
effect changes in these factors is rarely as simple as it may appear 67I, 8&&%, p #9!.
This model is a great tool to use in a wide variety of public health concerns today. I am doing
my health promotion on HI4:5I,' and drug awareness; this is a great model to use for these
topics. The way this model would be used is by<
$. ,efining what populations are at ris3 and their levels of ris3
%. Tailoring ris3 information based on the individual2s characteristics or behaviors
&. Helping the individual develop an accurate perception of his or her own ris3
'. 'pecifying the conse-uences of the condition and recommended action
(. =)plaining how, where, and when to ta3e action and what the potential positive results will
be
). >ffering reassurance, incentives, and assistance
*. (roviding 1how to1 information, promote awareness, and employ reminder systems
+. (roviding training and guidance in performing action
,. Using progressive goal setting
$-. ?iving verbal reinforcement
$$. ,emonstrating desired behaviors
5n e)ample of how this model applies to public health promotion is, high blood pressure
screening campaigns often identify people who are at high ris3 for heart disease and stro3e, but
who say they have not e)perienced any symptoms. Because they don2t feel sic3, they may not
follow instructions to ta3e prescribed medicine or lose weight. The HBM can be useful for
developing strategies to deal with noncompliance in such situations. 5ccording to the HBM,
asymptomatic people may not follow a prescribed treatment regimen unless they accept that,
though they have no symptoms, they do in fact have hypertension perceived susceptibility!.
They must understand that hypertension can lead to heart attac3s and stro3es perceived
severity!. Ta3ing prescribed medication or following a recommended weight loss program will
reduce the ris3s perceived benefits! without negative side effects or e)cessive difficulty
perceived barriers!. (rint materials, reminder letters, or pill calendars might encourage people to
consistently follow their doctors2 recommendations cues to action!. *or those who have, in the
past, had a hard time losing weight or maintaining weight loss, a behavioral contract might help
establish achievable, short-term goals to build confidence self-efficacy!.
Modifiable behavioral ris3 factors are leading causes of mortality in the United 'tates. The
leading causes of death in 8&&& were tobacco @9%, &&& deaths!, poor diet and physical inactivity
9A%, &&& deaths! and alcohol consumption B%, &&& deaths!. >ther actual causes of death were
microbial agents C%, &&&!, to)ic agents %%, &&&!, motor vehicle crashes @9, &&&!, incidents
involving firearms 8$, &&&!, se)ual behaviors 8&, &&&!, and illicit use of drugs #C, &&&!.
.These findings, along with escalating health care costs and aging population, argue persuasively
that the need to establish a more preventive orientation in the U' health care and public health
systems has become more urgent1 Mo3dad, Mar3s, and ?erberding, 8&&@!.
Deferences
Mo3dad, 5. H., Mar3s, E. '., 'troup, ,. *., ?erberding E. F. 8&&@!. 5ctual causes of death in the
United 'tates, 8&&&. JAMA, 291#&!, #89B-@%.
6ational 7ancer Institute, ,epartment of Health and Human 'ervices, 6ational Institutes of
Health. 8&&%!. Theory at a glance: A guide for health promotion practice 8
nd
ed.!. 6IH
(ublication 6o. &%-9B$A!. Detrieved from http<::www.cancer.gov:(,*:@B#f%d%9-A9df-@#bc-
bfaf-%aa@Bee#da@d:T55?9.pdf