1. 社區職能治療專題 Theoretical Framework for Community-Based Practice —Health Belief Model 報告者：鄭筱儒 報告日期： 09.27.2012 指導老師：毛慧芬老師

2. Outline Background Develop Concept Health-action link Psychometrics Applied area Related articles Reference

3. Background Developer: Hochbaum, Kegeles, Levenyhal, and Rosenstock Theory base: ◦Social psychology ◦Lewin’s aspiration theoryLewin’s aspiration theory Underlying premise: ◦Phenomenological orientation  Individual’s perceptions determine behavior ◦Ahistorical perspective  Current dynamics affecting an individual’s behavior

4. LEVEL OF ASPIRATION determined by two factors: ◦The person's relation to certain values ◦The person's sense of realism in regard to the probability of reaching the goal. successful person will chose goals that are within his or her capacity to reach, and will raise those goals once having achieved them.

5. Develop Researcher: Cummings, Becker, and Maile(1980) 6 factors: ◦1.access to health-care services ◦2.attitudes toward health care ◦3.perception of threat of illness ◦4.caracteristics of the social network ◦5.knowledge about disease ◦6.demographic characteristics

6. Concept Describes the relationship between a person’s beliefs about health and his or her health-specific behavior. Beliefs: Beliefs ◦Perceived susceptibility ◦Perceived severity ◦Perceived benefits ◦Perceived barriers Cues to action ◦An instigating event that stimulate the initiation of behavior(internal or external)

7. Beliefs Perceived susceptibility ◦Subjective impression of risk of contracting a disease or illness Perceived severity ◦Convictions regarding the degree of seriousness of a given health problem Perceived benefits ◦Beliefs regarding the availability and effectiveness of a variety of possible actions in reducing the threat of illness Perceived barriers ◦Costs or negative aspects associated with engaging in a specific health behavior

9. Concept Definition Application Perceived Susceptibility One's opinion of chances of getting a condition Define population(s) at risk, risk levels; personalize risk based on a person's features or behavior; heighten perceived susceptibility if too low. Perceived Severity One's opinion of how serious a condition and its consequences are Specify consequences of the risk and the condition Perceived Benefits One's belief in the efficacy of the advised action to reduce risk or seriousness of impact Define action to take; how, where, when; clarify the positive effects to be expected. Perceived Barriers One's opinion of the tangible and psychological costs of the advised action Identify and reduce barriers through reassurance, incentives, assistance. Cues to Action Strategies to activate "readiness" Provide how-to information, promote awareness, reminders. Self-Efficacy Confidence in one's ability to take action Provide training, guidance in performing action.

10. Health-action link

11. Psychometric Predictive validity in question Construct validity well defined ◦Causal associations between variables and factors are not addressed

12. Applied area Alcoholism Compliance with a diabetes regimen Breast self-examination Contraceptive behavior Medication compliance among psychiatric outpatients Medication compliance among psychiatric outpatients

13. Alcoholism 13

14. Compliance with a diabetes regimen Compliance with a diabetes regimen 14

15. 15 Breast self-examination Breast self-examination

16. Medication compliance among psychiatric outpatients Medication compliance among psychiatric outpatients 16

17. Related articles Community sreening: ◦StrokeStroke ◦Hepatitis CHepatitis C ◦CancerCancer

18. Stroke

19. ↑ adherence to screening advice and merits further testing ↑ adherence to screening advice and merits further testing

20. Hepatitis C

21. ↑ compliance with treatment regimens ↑ compliance with treatment regimens

22. Cancer

23. ↑ awareness of the need for CRC prevention and screening ↑ awareness of the need for CRC prevention and screening

24. Reference http://www.utwente.nl/cw/theorieenoverz icht/theory%20clusters/health%20commu nication/health_belief_model.doc/ http://www.utwente.nl/cw/theorieenoverz icht/theory%20clusters/health%20commu nication/health_belief_model.doc/

25. Thanks for listening

26. Q & A