1. Health Belief Model / Protection Motivation Theory
EPHE 348

2. 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

3. 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

4. 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)

5. 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

6. Components of the HBM Cues to Action
Body or environmental events that trigger the HBM

7. Health Belief Model

8. Additional Components?
Self-Efficacy
confidence to continue the healthy behavior and overcome temptations
Now an additional component of the HBM

9. Protection Motivation Theory (Rogers, 1984)
Extension and re-working of HBM
Intention to protect oneself is the proximal determinant of health behavior

10. 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”

11. Protection Motivation Theory

12. Where Do We Intervene? Fear appraisals Health education
Educate about threat (vulnerability, susceptibility)
Fear appraisals
Educate about coping (response efficacy, self-efficacy)
Health education

13. 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

14. 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.

15. 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