SEMINAR ON

HEALTH BELIEF
MODEL

Submitted to Submitted By
Mrs. Grace Mane Madam, Mr. Sagar S. Adhao
Lecturer, Institute of Nursing M.Sc. Nursing First Year
Education, Mumbai
Institute of Nursing Education,
Mumbai
AIM
At the end of the seminar the student will get the knowledge about Health Belief
Model and Concept of self Health.

OBJECTIVES
At the end of the seminar the student will able to –

Discuss the historical origine of the models.

 Define the health, models health beliefs

 Explain the factor influencing health and health beliefs

 Write the Rosenstock’s health belief model.

HISTORICAL ORIGINS OF THE MODEL

Lewin’s Field Theory (1935)

 Introduced the concept of barriers and to facilitators of behavior change US

Public Health Service (1950s) and updated in the 1980s
 Group of social psychologists trying to explain why people did not participate
in prevention and screening programs
 Two major influences from learning theory
a) Stimulus Response Theory
b) Cognitive Theory.

Stimulus Response Theory

 Learning results from events which reduce the psychological drives that cause
behavior (reinforces)
 In other words, we learn to enact new behaviors, change existing behaviors, and
reduce or eliminate behaviors because of the consequences of our actions.
 Reinforces, punishments, rewards.

Cognitive Theory

 Emphasize the role of subjective hypotheses and expectations held by the individual.
 Beliefs, attitudes, desires, expectations, etc.
 Influencing beliefs and expectations about the situation can drive behavior change,
rather than trying to influence the behavior directly.

Definitions

Health

 Traditionally, health was defined in the terms of presence or absence of the

disease.
 WHO defines health as a “state of complete physical, mental and social well-
being, not merely the absence of disease or infirmity.”

Model

A model is a theoretical way of understanding a concept or ideas.

Health Beliefs

Health Behaviours

These are the activities of the clients influenced by their heath beliefs. People take these
actions to maintain optimum health, prevent illness and reach their maximum physical and
mental potential.

There are two types of health behaviours:

1. Positive health behaviours.

2. Negative health behaviours.

Positive health behaviours: These are the activities related to maintaining, attaining or
regaining the good health and preventing illness. Common positive health behaviours include
immunization, adequate exercise, proper sleep pattern and good nutrition.

Negative health behaviours: These are the activities which are actually or potentially harmful
to the health. Common examples are smoking, drug and alcohol abuse, poor diet.

FACTORS INFLUENCING HEALTH AND HEALTH BELIEFS

There are many factors that can influence the health beliefs and practices of the
individual. The nurse should know these variables to plan and deliver individualise care.
These factors are of two types:

1. Internal factors.
2. External factors.

INTERNAL VARIABLES

Internal variables include a person's development stage, intellectual background, and

perception of functioning and emotional and spiritual factors.

Development Stage

A person's thought and behavior patterns change throughout life. The nurse must
consider the client's level of growth and development when using his or her health belief and
practice as a basis for planning care. The concept of illness for a child, adolescent, or adult
depends on the individual's development stage. Fear and anxiety are common among ill
children, especially if thoughts about illness, hospitalization, or procedures are based on lack
of information. Emotional belief may influence the personal belief about health-related
matters.
Intellectual Background

A person beliefs about health are shaped in part by the person’s knowledge, lack of
knowledge, or incorrect information about body functions and illnesses, educational
background and past experiences. These variables influence how a person think about the
health.

Perception of Functioning

The way people perceive their physical functioning affects health belief and practice.
When nurses assess a client’s level of health, they assess greater subjective data about the
way the client perceives the physical functioning such as level of fatigue, shortness of breath
or pain. They also obtain the objective data about actual functioning such as blood pressure,
height measurement and lung sound assessment. This information allows the nurses to more
successfully plan and implement individualized care.

Emotional Factors

The client’s degree of stress, depression, or fear, for example, can influence the way
the person handle: stress throughout each phase of life will influence the way the person
reacts to illness. A person who generally is very calm may have little emotional response
during illness, whereas an individual unable to cope emotionally with the threat of illness
may either overreact to illness and assume it is life-threatening symptoms and not take
therapeutic action.

Spiritual Variable

spirituality, it is reflected in how a person lives his or her life, including the values
and belief exercised, the relationships established with family and friends and the ability to
find the hope and meaning of life.

EXTERNAL VARIABLE

External variables influencing a person’s health belief and practice include family
practices, socioeconomic factors and cultural background.

Family Practice

The way that clients’ families use health care services generally affect their health practices.
Their perception of seriousness of the diseases and their history of preventive care behaviors
influence how client will think about health.
Socioeconomic Factors

Social and psychological factors increase the risk tor illness and influence the way
that a person defines and reacts to illness. Psychosocial variables include the stability of the
persons marital or intimate relationship, lifestyle habits and occupalional environment. A
person generally seeks approval and support from the social networks (neighbors. peers, co-
workers), and this desire for approval and support affects health beliefs and practice.

Cultural Background

Cultural background influences beliefs, Values, customs. It influences the approach to

the health care system, personal health practices, and the nurse-client relationship. Cultural
Background may also influence an individual’s belief about causes of illness, as well as
remedies or practices to restore health.

Rosenstock’s And Becker’s Health Belief Model

The Health belief Models (HBM) is a psychological model that attempts to explain
and predict health behaviours. This is done by focusing on the attitudes and beliefs of
individuals.

The health belief model, developed by researchers at the US Public Health Service in
the 1950s, was inspired by a study of why people sought X-ray examinations for tuberculosis.

In the 1950s, Rosenstock proposed a health belief model intended to predict which
individuals would or would not use preventive measures against the diseases. Becker
modified this model this model and included other components like individual perceptions,
modifying factors and variables likely to affect the initiating action.

It attempted to explain and predict a given health-related behavior from certain

patterns of belief about the recommended health behavior and the health problems that the
behavior was intended to prevent or control. The model postulates that the following four
conditions both explain and predict a health-related behavior:

1. A person believes that his or her health is in jeopardy. For the behavior of seeking
a screening test or examination for an asymptomatic disease such as tuberculosis,
hypertension, or early cancer, the person must believe that he or she can have the
disease yet not feel symptoms. This constellation of beliefs was later referred to
generally as “belief in susceptibility.”
2. The person perceives the “potential seriousness” of the condition in terms of pain
or discomfort, time lost from work, eco-nomic difficulties, or other outcomes.
3. On assessing the circumstances, the person believes that benefits stemming from
the recommended behavior outweigh the costs and inconvenience and that they
are indeed p0SSible and within his or her grasp. Note that this set of beliefs is not
equivalent to actual rewards and barriers (reinforcing factors). In the health belief
 model, these are “perceived” or “anticipated” benefits and costs (predisposing
factors).

Concept Definition Application

One's opinion of Define population(s) at risk, risk levels; personalize
Perceived
chances of getting a risk based on a person's features or behavior;
Susceptibility
condition heighten perceived susceptibility if too low.
One's opinion of how
serious a condition and
Perceived Severity Specify consequences of the risk and the condition
its consequences are

One's belief in the

efficacy of the advised
Define action to take; how, where, when; clarify the
Perceived Benefits action to reduce risk or
positive effects to be expected.
seriousness of impact

One's opinion of the

tangible and
Identify and reduce barriers through reassurance,
Perceived Barriers psychological costs of
incentives, assistance.
the advised action

Strategies to activate
Provide how-to information, promote awareness,
Cues to Action "readiness"
reminders.

Confidence in one's
Self-Efficacy ability to take action Provide training, guidance in performing action.

4. The person receives a “ cue to action” or a precipitating force that makes the
person feel the need to take action.

Core Assumption and Statements

The HBM is based on the understanding that a person will take a health-related action
(.e, Vaccination), if that person:

 Feels that a negative health condition (i.e.communicable disease) can be avoided

 Has a positive expectation that by taking a recommended action, he/she will avoid a
negative health condition (i.e. vaccination will be effective at preventing
communicable diseases.)

 Believes that he/she can successfully take a recommended health action (i.e.
vaccination is safe to be used and has an acceptable level of risk).

Rosen stock assumed that health is an objective common to all people.

This model has three components

1. Individual’s perception of susceptibility to an illness.

2. Individual’s perception of seriousness of illness.
3. Likelihood that the person will take preventive action.

The health belief model helps the nurses to understand the factors influencing the
client’s perceptions, belief and behavior in order to plan care that will most effectively
assist the client in maintaining or restoring health and preventing illness.
Fig. purpose of the model
Individual Perception
Individual perceptions include the following:

Perceived susceptibility: lt is one’s opinion of chances of getting a condition. It makes the

individual to feel at high-risk to a disease like family history of cardiac disorder, diabetes.

Perceived seriousness: It is one’s opinion of how serious a condition and its consequences
are. It makes the individual to think that whether the ilness causes death or has serious
consequences. For example, concern about the spread of AIDS reflects the people’s
perception of the seriousness of the disease.

Perceived threat: Perceived susceptibility and perceived seriousness combine to determine the
total perceived threat of an illness to a specific individual. For example, a drug addict or a
homosexual has more perceived threat of AIDS than a normal person because the
susceptibility is combined with the seriousness.

Self efficacy: Sell-efficacy is another related concept, introduced by Albert Bandura.

Although someone may believe that how some future event turns out is under his control, he
may or may not believe that he is capable of behaving in a way that will produce the desired
result,

For example, an athlete may believe that training eight hours a day would result in a marked
improvement in ability (an internal locus of control orientation) but not believer that he or she
is capable of training that hard (a low sense of self-efficacy).

Modifying Factors
Factors that modity a persons perception. include the following:

 Demographic variables: Demographic variables include age, gender, race and

ethnicity, For example, an adolescent may perceive peer approval as more important
than family approval and thus, participates in hazardous activities or adopt unhealthy
eating and sleeping patterns.
 Sociopsychological variables: Social pressure such as influence from peers or others
also affect the individual’s perception and can encourage preventive health behaviors
even when individual’s motivation is low.
 Structural variables: Structural variables that affect the individual's perception about
the disease are knowledge about the disease and prior contact with it.
 Cues to action: Strategies to activate “readiness” cues can be internal or external.
Internal cues include-negative feelings about the condition of a person suffering from
the disease. External cues are like mass media campaigns, newspaper or magazine,
articles, advice from others.
Likelihood of Action
 The likelihood of a person's taking recommended preventive health.
 Action depends on the perceived benefits of action minus the perceived barriers to the
action
o Perceived benefits of the action: One’s belief in the efficacy of the advised
action to reduce risk or seriousness of impact Before taking the action, the
individual thinks about its benefits to him. For example, avoiding smoking to
prevent lung cancer, eating the nutritious food to maintain the weight.
o Perceived barriers to the action: These are the hindrances like cost,
inconvenience and lifestyle changes.
o Self-efficacy: Self-efficacy is another related concept, introduced by Albert
Bandura. Although someone may believe that how some future event turns out
is under his control, he may or may not believe that he is capable of behaving
in a way that will produce the desired result. For example, an athlete may
believe that training eight hours a day would result in a marked improvement
in ability (an internal locus of control orientation) but not believe that he or
she is capable of training that hard (a low sense of self-efficacy).
Vaccination Use Example

1.Perceived Mother believes that their infants are at high risk

susceptibility to communicable diseases like poliomyelitis

2.Perceived severity Mothers believe that these diseases are highly

infectious and spread easily.

3. Perceived benefits She believes that the recommended action of using

vaccination is safe to be used and would protect the
infant from getting infected with polio.

4.Perceived Barriers She identified her personal barriers to use vaccination

5.Cues to action Mother receives the reminder cues for action in the
form of incentives( such as messages on TV and
Newspapers)

SUMMARY

In this topic we have seen about

  Historical origine of the models.

 Health, models health beliefs

 Factor influencing health and health beliefs

 Rosenstock’s health belief model.

 Vaccination use example.

CONCLUSION
At the end of this seminar I conclude that students got knowledge about health belief
model.
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