HEALTH BELIEF MODEL (HBM)

Self care is a vital part of maintaining good health and a vibrant life but some people especially FIlipino nurses
who work abroad don’t have time to appreciate or partake in these programs because of many factors such as
they don’t feel the need of it, or they may not do this because of they are busy taking care of other people. The
Health Belief Model (HBM) can be useful for developing strategies to deal with noncompliance in such
situations.

The Health Belief Model (HBM) was one of the first health behavior theories and remains one of the most
widely used models recognized in the field for interpreting health habits. It was developed by a U.S. group in
the 1950s. With this theory, we can use it to explain and predict changes of ​Filipino nurses working abroad on
health behaviors. This theory addresses the Filipino nurses’ perceptions of the threat posed by a health
problem that arises from their experiences in their work abroad, the benefits of avoiding this threat, and factors
influencing the decision to act. According to HBM, There are six main constructs that influence Filipino nurses’
decisions about whether they will take action to prevent or screen for mental health problems or partake in
health promotion programs on how to take care of themselves. They will act if they believe that they are
susceptible to the condition (​perceived susceptibility)​ , the condition has serious consequences (​perceived
severity​), taking action would reduce their susceptibility to the condition or its severity (​perceived benefits)​ ,
costs of taking action are outweighed by the benefits (​perceived barriers​), if they’re exposed to factors that
prompt action (​cue to action​), and if they are confident in their ability to successfully perform an action
(​self-efficacy​). HBM is a good fit to address problematic behaviors that raise health issues. Health motivation
which is the central focus of HBM and the six constructs of the HBM will produce a useful framework for
creating short-term and long-term behavior change strategies.

According to the HBM, Filipino nurses may not partake in self care health promotion programs or do self care
regimen unless they accept that, though they have no reason to do it, some of them are unstable (perceived
susceptibility). Filipino nurses must understand that not taking care of themselves can lead to health problems
(perceived severity). Taking care of themselves physically, emotionally, mentally, and spiritually will reduce the
risks (perceived benefits) without negative side effects or excessive difficulty (perceived barriers). Print
materials, reminder letters, or schedules might encourage Filipino nurses to consistently follow self care
program’s recommendations (cues to action). For those who have, in the past, had a hard time taking care of
themselves, a behavioral contract might help establish achievable, short-term goals to build confidence
(self-efficacy).

ECOLOGICAL HEALTH PERSPECTIVE:

Intrapersonal level is one of the ecological health perspective levels of influence for health-related behaviors
and conditions that are defined as individual characteristics that influence behavior. In relation to the Health
Belief Model, Filipino nurses’ decisions on taking action to take care of themselves are influenced by their
knowledge, attitudes, beliefs, personality characteristic, motivation, self-concept, developmental history, past
experience, and skills.

OBJECTIVES:
1.) To know what factors that influence Flipino nurses’ decisions to take action on self care promotion
2.) To assist Filipino nurses to develop achievable short-term and long-term goals to build confidence to
take care of themselves
3.) To encourage Filipino nurses to partake in behavioral change strategies
STRATEGIES:

HEALTH BELIEF MODEL

CONCEPT STRATEGIES

Perceived susceptibility • Assess the level of risk of Filipino nurses employed in another country
• Tailor risk information based on the characteristics or behavior of Filipino
nurses
• Help Filipino nurses develop an accurate perception of their own risk

Perceived severity • Indicate the consequences of a condition and recommended action

Perceived benefits • Explain to Filipino nurses on how, where and when action is to be taken
and what the potential positive outcomes will be.

Perceived barriers • Offer reassurance, incentives, and assistance to Filipino nurses; correct
misinformation so they will have an accurate knowledge

Cues to action • Provide Filipino nurses a "how to" information, promote self-care
awareness, and engage in reminder systems

Self-efficacy • Provide preparation and guidance on the implementation of actions

• Employ progressive goal setting
• Provide verbal reinforcement
• Exhibit desired behaviors

OUTCOME GOALS:
1.)
2.)
3.)

STAGES OF CHANGE (TRANSTHEORETICAL) MODEL

The Stages of Change ​also called the Transtheoretical Model is ​developed by Prochaska and DiClement.
The basic premise of the model is that behavior change is a process, not an occurrence. This theory explains
how an individual or organization incorporates new behaviors, objectives and programs at different
levels.When Filipino nurses want to change a behavior, he or she goes through five stages: precontemplation,
contemplation, preparation, action, and maintenance. The first stage is precontemplation in which Filipino
nurses have no intention of taking action or taking care of themselves. The second stage is contemplation in
which Filipino nurses intend to take action and plan to take care of themselves in the near future.The third
stage is Preparation in which Filipino nurses have an intention to take action and have taken some behavioral
steps in taking care of themselves. The fourth stage is Action in which behavior of Filipino nurses has been
changed for a short period of time. The last stage is Maintenance in which behavior of Filipino nurses has been
changed and continues to be maintained for the long-term. At each stage, various intervention strategies will
help Filipino nurses progress on to the next stage and through the model. Filipino nurses within the community
are likely to differ in their openness or readiness to change. Furthermore, it is essential to recognize that
movement through this model is cyclical – Filipino nurses can move to the next stage or move back to the
previous stage.

The Stages of Change (Transtheorethical) Model offers perspective on ways to approach this health problems
that Filipino nurses experience or may experience. First, the model can be employed to help understand and
explain why Filipino nurses are not taking care of themselves. Second, it can be used to develop a self care
promotion program to help Fiilipino nurses to change their behavior, and maintain that change. Asking simple
questions can assess what stages of contemplation potential program Filipino nurses are in.

For example:
• Are you interested in self-care promotion? (Pre-contemplation)
• Are you thinking about taking care of yourselves soon? (Contemplation)
• Are you ready to plan how you will take care of yourselves? (Preparation)
• Are you in the process of trying to take care of yourselves? (Action)
• Are you trying to stay taking care of yourselves? (Maintenance)

The Filipino nurses' responses will help define where the participants are in the process of change and tailor
messages, strategies and programs that are relevant to their needs​. Filipino nurses who works in other country
are not interested in trying to take care of themselves because of their busy schedules, and therefore will not
attend a self care promotion program; for them, a more appropriate intervention might include educational
interventions designed to move them out of the “precontemplation” stage and into “contemplation” (e.g., visual
presentations of what are the benefits of self-care). On the other hand, Filipino nurses who are ready to plan
how to take care of themselves (the “preparation” stage) can be encouraged to do so, and moved to the next
stage, “action.”

In relation to the ecological health perspective, stages of change or transtheoretical model is under
intrapersonal levels of influence which are defined as individual characteristics that influence behavior. Filipino
nurses' attitude and interest in taking care of themselves influence the progression or regression of movement
in stages in this model.

OBJECTIVE:
1) To help Filipino nurses to progress on to the next stage and through the model.
2) To help Filipino nurses to recognize that this model has cyclical movement
3) To guide Filipino nurses not to regress or move back to the previous stage

STRATEGIES:

STAGES OF CHANGE (TRANSTHEORETICAL) MODEL

CONCEPT STRATEGIES

Pre-contemplation • Increase awareness of the need for change among Filipino nurses;
personalize risk and benefit information for Filipino nurses

Contemplation • Motivate Filipino nurses; encourage them to develop specific plans

Preparation • Assist in the development and implementation of concrete action plans of

Filipino nurses; help to set progressive goals;

Action • Help Filipino nurses with feedback, problem-solving, social support, and
reinforcement

Maintenance • Assist Filipino nurses with coping, reminding and seeking alternatives

OUTCOME GOALS:
1.)
 2.)
3.)

SOCIAL COGNITIVE THEORY (SCT)

ECOLOGICAL HEALTH PERSPECTIVE:

OBJECTIVES:
1.)
2.)
3.)

STRATEGIES:

SOCIAL COGNITIVE THEORY (SCT)

CONCEPT STRATEGIES

OUTCOME GOALS:
1.)
2.)
3.)

HEALTH INDICATORS
Behavioral Change Theory
Theory gives planners tools for moving beyond intuition to design and evaluate health behavior and health
promotion interventions based on understanding of behavior. It helps them to step back and consider the
larger picture. Like an artist, a program planner who grounds health interventions in theory creates
innovative ways to address specific circumstances.

Theory of Change
Change theory guides the development of health interventions. It spells out concepts that can be
translated into program messages and strategies, and offers a basis for program evaluation. Change
theory helps program planners to be explicit about their assumptions for why a program will work.
Examples of change theories include Community Organization and Diffusion of Innovations. Figure 1.
illustrates how explanatory theory and change theory can be used to plan and evaluate programs.

Theory of Planned Behavior

The Theory of Planned Behavior​ started as the Theory of Reasoned Action in 1980 to predict an individual's
intention to engage in a behavior at a specific time and place. The theory was intended to explain all behaviors
over which people have the ability to exert self-control. The key component to this model is behavioral intent;
behavioral intentions are influenced by the attitude about the likelihood that the behavior will have the expected
outcome and the subjective evaluation of the risks and benefits of that outcome.

The immigrant Filipino nurses’ intention to perform a behavior is predicted by their attitude toward the behavior
and subjective norms regarding the behavior.
Subjective norms are the result of social and environmental surroundings and a person's
perceived control over the behavior.
Objective:
1. To increase knowledge and modify attitudes, beliefs, and behaviors, using the Theory of Planned
Behavior as a guide.
2.
Strategy to
● Assess the degree to which the immigrant Filipino nurses intends to change their behavior towards their
surroundings
● Discuss the positive and negative expectancies the immigrant Filipino nurses has for their planned behavior, and
provide feedback about incorrect expectancies
● Ask the client whether family members and friends support tobacco use
● Draw attention to the social pressure to quit using tobacco
● Provide contact with others who have quit using tobacco
● Work to build self-efficacy for quitting smoking and staying quit in challenging situations

Outcome Goal:
● The immigrant Filipino nurses is able to…..

ECOLOGICAL PERSPECTIVE

The ecological perspective emphasizes the interaction between, and interdependence of, factors within and across all
levels of a health problem. It highlights people’s interactions with their physical and sociocultural environments. Two key
concepts of the ecological perspective help to identify intervention points for promoting health: first, behavior both affects,
and is affected by, multiple levels of influence; second, individual behavior both shapes, and is shaped by, the social
environment (reciprocal causation).

Visuals
Brochure and Poster