Health Belief Model Theory & Models PDF

1. The health belief model (HBM) It stipulates that the willingness of people to take health-related action depends upon their attitudes and beliefs about the: Threat posed by the health problem (susceptibility, severity). Benefits of avoiding the threat (benefits) Facto...

1. The health belief model (HBM) It stipulates that the willingness of people to take health-related action depends upon their attitudes and beliefs about the: Threat posed by the health problem (susceptibility, severity). Benefits of avoiding the threat (benefits) Factors influencing the decision to act (barriers, cues to action, and self-effi cacy) 11/06/2024 1  Components of the HBM Perceived susceptibility: One’s perception of the chances he or she will contract a health condition. Perceived severity: One’s perception of how serious a condition might be and its medical, clinical, or social consequences. Perceived benefi ts: One’s confidence in the eff ectiveness of the behavior to reduce the threat of the health condition. Perceived barriers: One’s perception of the negative factors (physical, emotional, financial, and social) for taking action. Cues to action: Factors that motivate or remind one to take action. Self-efficacy: One’s confidence in the ability to take action and the perception that successfully executing the behavior will produce a desired outcome. 11/06/2024 2  HEALTH BELIEF MODEL Individual perception Modifying Factors Likelihood of action Demographic variables (OUT COME Socio-psychological EXPECTATION) variables (personality, peer Perceived benefits of pressure etc) preventive action Structural variables (e.g. Minus knowledge about the Perceived barriers to Perceived disease. preventive action susceptibility to Disease "X“ Perceived Perceived threat Likelihood of taking of Disease "X" seriousness recommended (Severity) of Disease "X" preventive health Cues to action Mass media campaigns action Advice from others Reminder postcard from health workers Illness of family member or friend 11/06/2024 3  Health belief model… A person's motivation to undertake a health behavior can be divided into three main categories: 1. Individual perceptions, 2. Modifying behaviors, and 3. Likelihood of action. 4  Health belief model… Individual perceptions are factors that affect the perception of illness or disease. It includes: general health value, perceived susceptibility, and perceived severity. Modifying factors include demographic variables, perceived threat, and cues to action. The likelihood of action is the likelihood of taking the recommended preventive health action. 5  Perceived threat Is made up of the perception that one is susceptible to illness (i.e. Personal risk) & the perception that the illness is serious. The perception of personal health threat is influenced by at least three factors:  General health values  specific beliefs about vulnerability &  Beliefs about the consequences of the disorder. 6  Out come expectation  Is made up of the perceived benefits of the specified action minus the perceived barriers to the action.  Overall, perceived barriers to the practice of the health behavior is the most powerful dimension influencing whether or not people actually practiced a particular health behavior. Once an individual perceives a threat to his/her health and is simultaneously cued to action, and his/her perceived benefits outweighs his/her perceived barriers, then that individual is most likely to undertake the recommended preventive health action. 7  Summary of Health Belief Model (Constructs, Definition & Application) Concept Definition Application/Change Strategies Perceived Beliefs about the chances of Define what populations(s) are at risk and their Susceptibility getting a condition, i.e. levels of risk; Tailor risk information based on an disease, risk, accident, etc individual’s characteristics or behaviors; Help the individual develop an accurate perception of his or her own risk Perceived Beliefs about the seriousness Specify the consequences of a condition Severity of a condition and its consequences, i.e. suffering, impairment, death & its sequelea Perceived One's perception of the Define action to take; how, where, when; clarify Benefits efficacy (instrumentality) of the positive effects to be expected. the desired action/behavior/ to reduce the risk or seriousness of the disease or its impact 8 Summary of Health Belief Model (Constructs, Definition & Application) Concept Definition Application/Change Strategies Perceived One's perception of the tangible Identify and reduce barriers through reassurance, Barriers and intangible(psychological, incentives, assistance emotional, social, etc.) costs of the desired or proposed behavior for action Cues to Action Strategies to activate "readiness" Provide how-to-get full information, promote awareness, and activate latency of decision implementation. Self-Efficacy Confidence in one's ability to Provide training, guidance in performing action. take action 9  Theory of Reasoned Action (TRA) It suggests that behavior can be predicted because behavior can be planned. If the individual has intention, they can be predicted and then planned and practiced (positive), and can also be prevented (for unhealthy behaviors). So far, behaviors explored using TPB include smoking, alcohol drinking, contraceptive use, dieting, wearing seat belts, exercising regularly, voting, and breastfeeding 11/06/2024 10  Assumption:- The theory rests on the assumptions that humans are: - rational, - have control over their behavior, and - seek out, utilize, and process all available information about pending decisions before they take actions (Crawley & Koballa, 1994). 11/06/2024 11  The theory of reasoned action. Behavioral belief & Attitude Outcome Evaluation BEHAVIOR INTENTION ` Normative beliefs of referents Subjective norms & Motivation to comply 12  TRA…. Intentions are most immediate influence or determinant of behaviors If one has intent to perform a behavior then it is likely that he/she will do so, if not intend then it is unlikely to be performed. Performing a behavior is a function of intention to perform the behavior 11/06/2024 13  TRA…. Intention:- function of two basic determinants: one personal and the other social  Personal factor = attitude toward the behavior The social factor = subjective norm (SN) SN is the person's perception of the social pressures put on that person to perform or not perform the behavior in question. 11/06/2024 14  TRA…. The importance of the two components (attitude & subjective norm) in determining intentions may vary from one behavior to another and from one individual to another In general, individuals will intend to perform a behavior when they evaluate it positively and when they believe that important others think they should perform it. 11/06/2024 15  TRA…. Determinants of Attitude toward an Act -Behavioral beliefs = The person’s beliefs that the behavior leads to certain outcomes and - Evaluation of outcome = his or her evaluations of those outcomes 11/06/2024 16  TRA…. An attitude toward a behavior can be predicted by the product of the outcome evaluation and belief strength  Implications of this approach: Two people may have the same set of beliefs about a behavior but a totally different attitude because of different outcome evaluations or belief strengths 11/06/2024 17  TRA…. Determinants of Subjective Norms 1. Normative beliefs 2. Motivation to comply 1. Normative beliefs = belief about what a specific referent person thinks one should or should not do regarding the behavior Referent = specific individual or group who may influence one’s behavior 11/06/2024 18  TRA…. For any given behavior at a given time, we will have a set of salient referents 1 For each referent, we have a normative belief, what we think that referent would want us to do 2. For each referent, we have a specific level of motivation to comply with their wishes for us 11/06/2024 19  TRA…. E.g. If some one believes that other people think he/she should stop smoking or chewing chat ,and motivated to comply with those normative beliefs then he/she may assume that it is a norm(subjective) 11/06/2024 20  Tr a n s t h e o r e t i c a l m o d e l (stages of change) Evidence suggest that behavior change occurs in stages or steps Movement through these stages is not linear But, rather cyclical involving pattern of adoption, maintenance, relapse & re-adoption over time. Prohasska and Di-clemente ( 1984 ) have formally identified the dynamics and structure of staged behavior change 11/06/2024 21 Stages of change 1. Precontemplation 2. Contemplation 3. Decision 4. Action 5. Maintenance 6. Termination 22  STAGES OF BEHAVIOR CHANGE 1)Precontemplation(“ignorance is bliss”)  Person does not thinking about changing behavior 2) Contemplation(“sitting on the fence”)  Thinking about changing behavior in the near future  People are aware that a problem exist and are seriously considering taking some action to address the problem -but, they have no commitment to undertake action 23  3) Preparation (testing the waters) Making a plan to change behavior Person decided to act Prepares to under take the desired change Requires : -gathering information -finding out how to achieve the change -ascertaining skills necessary -deciding when change should take place` 24  4) Action (“go for it”) Implementing the plan to change behavior Individuals actually modify their behavior, experiences, or environment in order to overcome their problems or to meet their goals 25  5) Maintenance (“steady as she goes”) Continuation of behavior change People work to prevent relapse & consolidate the gains attained in the action stage Characteristics : -Stabilization of the new behavior -Avoidance of relapse 6. Termination The person has zero temptation and ability to resist relapse. 26  Social Cognitive Theory (SCT) Social Cognitive Theory (SCT) describes a dynamic, ongoing process in which personal factors, environmental factors, and human behavior exert influence upon each other According to SCT, three main factors affect the likelihood that a person will change a health behavior: (1) self-efficacy, (2) goals, and (3) outcome expectancies. If individuals have a sense of personal agency or self- efficacy, they can change behaviors even when faced with obstacles. 11/06/2024 27  SCT….. Self-efficacy is the core concept in SCT Self-efficacy is the perception of one’s own capacity for success in organizing & implementing a pattern of behavior that is new, based largely on experience with similar actions or circumstances encountered or observed in the past 11/06/2024 28  SCT… Strategies for increasing self-efficacy include:  Setting incremental goals (e.g., exercising for 10 minutes each day);  Behavioral contracting (a formal contract, with specified goals and rewards); and  Monitoring and reinforcement (feedback from self- monitoring or record keeping) 11/06/2024 29  SCT….. According to the theory learning takes place through: 1. Direct experience: learning by doing 2. Indirect or vicarious experience: learning through observing others doing the job 3. Cognitive learning: the storing & processing of complex information (evidence based) 11/06/2024 30 Key Constructs of The Theory 31 Key Constructs of The Theory 32  Diffusion of innovations theory (DOI) A process by which innovation is communicated through certain channels over time among the members of a social system. The four main elements of the definition are: I. Innovation II. Communication channels III. Time IV. Social system 11/06/2024 33  I. Innovation Idea, practice, or object that is perceived to be new by an individual or other unit of adoption - The Characteristics which determine an innovation’s rate of adoption are: 1. Relative advantage -is the degree to which an innovation is perceived as better than the idea it replace 34  Characteristics… 2. Compatibility -is the degree to which an innovation is perceived as being consistent with the existing values, past experiences, and needs of potential adopters 3. Complexity -is the degree to which an innovation is perceived as difficult to understand and use 35  Characteristics… 4. Trialability -is the degree to which an innovation may be experimented with on a limited basis 5. Observability -is the degree to which the results of an innovation are visible to others 36  II) communication channels -It is the means by which messages get from one individual to another. Mass media Interpersonal 37  III. TIME - the three time factors are: (a) Innovation-decision process (b) Innovativeness (c) Innovation's rate of adoption 38  a) The Innovation - Decision Process /The Adoption Process / - the process an individual passes from first knowledge of an innovation to confirmation of his decision. Five stages through which innovation passes: 39  5 stages of Innovation-Decision Process… 1. Awareness/knowledge-exposure to existence of the innovation 2. Interest/persuasion-the individual becomes interested in the new idea -seeks additional information about it 3. Evaluation/decision-individual mentally applies the innovation to his present and anticipated future situation -and then decides whether or not to try it -commitment to its adoption 40  5 stages… 4. Trial/implementation-the individual makes full use of the innovation 5. Adoption/confirmation-the individual decides to continue the full use of the innovation -reinforcement based on positive outcomes from it Re-invention, Rejection and Discontinuance 41  Re-invention, Rejection and Discontinuance Re-invention - the degree to which an innovation is changed or modified by a user in the process of its adoption Rejection - decision not to adopt an innovation Discontinuance: is a rejection that occurs after adoption of the innovation. -disenchantment -dissatisfaction with it's performance -replacement- adopt a better idea 42  b) ADOPTER CATEGORIES based on their innovativeness Diffusion process - occurs within society, as a group process; Adoption process-pertains to an individual. Adopter Categories according their innovativeness: 1. Innovators - active information seekers of new ideas - are the first 2.5% of the individuals in a system to adopt an innovation 43  2. Early adopters very interested in the innovation but not the first to sign up the next 13.5% of the individuals in a system to adopt an innovation Characteristics: - Integrated part of the local social system, - Greatest degree of opinion leadership in most systems, - Serve as role model for other members or society, - Respected by peers, and - Successful 44  3. Early majority Is the next 34% of the individuals in a system to adopt an innovation. Need external motivation to get involved - Interact frequently with peers - Seldom hold positions of opinion leadership - Deliberate before adopting a new idea 45  4. Late majority Is the next 34% of the individuals in a system to adopt an innovation. Are skeptics and will not adopt an innovation until most people in the social system have done so - Pressure from peers, - Economic necessity, - Cautious 46  5. Laggards Are the last 16% of the individuals in a system to adopt an innovation. Last to become involved by a mentoring program or through constant exposure and have limited communication networks - Possess no opinion leadership - Isolates - Suspicious of innovations 47  Cumulative percentage of adopters % 2.5 % 13.5 % 34 % 34 % 16 48  c) THE RATE OF ADOPTION The relative speed with which an innovation is adopted Measured by number of adopters at a given time Influenced by characteristics of the innovation 49 Diffusion of different innovations 50