Health Belief Model /

Protection Motivation
Theory

EPHE 348
 History of the HBM

 Developed in the 50’s by the U.S. Public Health

Service

 Social psychologists were asked to explain why

people do not participate in health behaviors
(Rosenstock, 1960; 1966)

 Developed based on operant and cognitive-

behavioral theory
 Premise of the HBM
 Individuals will take action to ward off, to screen
for, or to control an ill health condition if:
 1) they regard themselves as susceptible to the
condition
 2) they believe it to have potentially serious
consequences
 3) they believe a course of action can reduce the
susceptibility and seriousness
 4) they believe the costs of the action are outweighed
by its benefits
 Components of the HBM

 Perceived Susceptibility
 an individual’s perception of her or his risk of contracting a health
condition

 Perceived Severity
 an individual’s perception of the seriousness of a health condition
if left untreated

 Note: the combination of these is the perceived threat of the health

condition (emotive response is fear)
Components of the HBM

 Perceived Benefits
 the perceived effectiveness of taking action
to improve a health condition

 Perceived Barriers
 the perceived impediments to taking action
to improve a health condition
Components of the HBM

 Cues to Action
 Body or environmental events that trigger
the HBM
 Health Belief Model

Barriers
Benefits

Severity

Threat

Susceptibility Health
Behavior

Cues to
Action
Additional Components?

 Self-Efficacy
 confidence to continue the healthy
behavior and overcome temptations

 Now an additional component of the

HBM
Protection Motivation Theory
(Rogers, 1984)

 Extension and re-working of HBM

 Intention to protect oneself is the

proximal determinant of health behavior
 Protection Motivation Theory

 Intention is dependent on four components:

 1) perceived susceptibility
 2) perceived severity
 3) Self-efficacy
 4) Response efficacy (benefits versus barriers)

 Susceptibility and severity are considered “perceived

threat”
 Response efficacy and self-efficacy are considered
“coping efficacy”
Protection Motivation Theory

Severity

Threat

Susceptibility
Health
Intention Behavior

Self-
Efficacy Coping
Efficacy
Response
Efficacy
 Where Do We Intervene?

 Educate about threat (vulnerability, susceptibility)

 Fear appraisals

 Educate about coping (response efficacy, self-efficacy)

 Health education
 Evaluating the HBM/PMT
 APPLICABILITY TO PRACTICE (IS IT USEFUL?)

 Coping efficacy is the most important component

 Self-efficacy (and perceived barriers) is the most influential
component for health behavior

 Perceived severity is the weakest component

 Health behaviors are long-term?

 Perceived vulnerability often influences intentions but not

behavior
 Evaluating the HBM/PMT

 COMPREHENSIVE (Does it explain behavior completely?)

 No

 What about other motives for behavior other than

health? These motives appear untapped for explaining
behavior.
 Application Exercise

 Please choose a health behavior and population

 Assume you are an advertising specialist contracted to

develop a persuasive communication (poster, news
advertisement etc.) to improve the health behavior for the
population

 Create a message that includes severity, susceptibility,

response efficacy, and self-efficacy for the target
population