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 Perceived Barriers 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

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

Where Do We Intervene? Fear appraisals Health education 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