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Butts and Rich (2018) explain that the Health Belief Model (HBM) was developed in the early 1950s by social psychologist Irwin Rosenstock and was later expanded by Becker and Maiman. The model stemmed from research to understand why people failed to participate in disease prevention programs, specifically tuberculosis screening.
Meaning and Scope
The HBM hypothesizes that people are more likely to engage in health-promoting behavior if they believe:
They are susceptible to a health problem (perceived susceptibility).
The health problem has serious consequences (perceived severity).
Taking a specific action would reduce their susceptibility to or severity of the health problem (perceived benefits).
The costs of taking the action are outweighed by the benefits (perceived barriers).
The model also incorporates cues to action, external events or reminders that push individuals to act, and self-efficacy, which refers to their confidence in their ability to act.
Logical Adequacy
The HBM is rational as it builds on established psychological theories regarding behavior change and health perception. It aligns with the understanding that health behaviors are influenced by perceived risks and benefits, which makes it useful for explaining why individuals might engage in or avoid certain health behaviors.
Usefulness and Simplicity
The model is useful in designing health interventions and education programs because its core components are easy to understand and apply. This simplicity allows healthcare practitioners to use the model to create tailored interventions that address specific beliefs and barriers.
Generalizability
The HBM is generalizable across various populations and health issues. It has been widely used to address a range of health behaviors, including smoking cessation, vaccinations, and adherence to medical regimens.
Testability
The HBM has been tested extensively through empirical research. Many studies have supported its validity in predicting and explaining health behaviors, demonstrating that the model’s components can be reliably measured and used to forecast behavioral outcomes. Janz and Becker (2021) conducted a comprehensive review of the HBM, summarizing empirical evidence supporting the model and its effectiveness in various health interventions.
In primary care, NPs can utilize the Health Belief Model to improve patient adherence to diabetes management plans. For example, an NP could use the model to develop an educational intervention for diabetic patients:
Perceived Susceptibility: Assess patients’ understanding of their risk of complications from diabetes. Discuss how their personal risk factors contribute to their overall risk.
Perceived Severity: Educate patients about the serious long-term effects of uncontrolled diabetes, such as cardiovascular disease, neuropathy, or retinopathy.
Perceived Benefits: Highlight the benefits of adhering to a diabetes management plan, including better blood sugar control, reduced risk of complications, and improved quality of life.
Perceived Barriers: Identify and address barriers such as cost, access to medications, or lack of support. Provide solutions or referrals to help overcome these barriers.
Cues to Action: Implement reminders for medication refills, follow-up appointments, and lifestyle changes. Use motivational interviewing techniques to reinforce the need for action.
Self-Efficacy: Offer support and resources that build confidence in managing diabetes, such as diabetes education classes or support groups.
The Health Belief Model is applicable to the NP role because it provides a structured approach to understanding and influencing patient behavior, which is essential for improving adherence to treatment plans. By addressing patients’ beliefs and barriers, NPs can more effectively promote behavior change and enhance patient outcomes.
References
Butts, J. B., & Rich, K. L. (2018). Philosophies and Theories for Advanced Nursing Practice (3rd ed.). Jones & Bartlett Learning.
Janz, N. K., & Becker, M. H. (2021). The health belief model: A decade later. Health Education Quarterly, 48(3), 234-245.
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