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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)

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History of the hbm
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
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
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 hbm1
Components of the HBM

  • Perceived Benefits

    • 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 hbm2
Components of the HBM

  • Cues to Action

    • Body or environmental events that trigger the HBM



Additional components
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
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
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”



Where do we intervene
Where Do We Intervene?

  • Educate about threat (vulnerability, susceptibility)

    • Fear appraisals

  • Educate about coping (response efficacy, self-efficacy)

    • Health education


Evaluating the hbm pmt
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 pmt1
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
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


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