Where does health belief model collide?

The model that predicts whether a person takes a preventive health action from a small set of beliefs: how likely they think they are to get a condition (perceived susceptibility), how serious they think it would be (perceived severity), how much they think an action would help (perceived benefits), and what they think it would cost them (perceived barriers), together with cues to action and a person's general health motivation. Rosenstock's 1974 account traces the model to work by Hochbaum, Kegels, and Leventhal in the U.S. Public Health Service in the 1950s on why people did or did not take up free screening. In this framing susceptibility and severity combine into a sense of threat from the condition, which is the belief the rest of this map keeps renaming. Rosenstock, Strecher, and Becker added self-efficacy, the belief that one can carry out the action, as a separate variable in 1988, drawing it from Bandura's social learning theory. The model is descriptive rather than a piece of advice, and it says nothing about which beliefs are correct.[1][2]

Unit

A person's beliefs about a health threat and a preventive action

Recovery means

Not applicable

Measured by

Self-report scales for susceptibility, severity, benefits, and barriers; a health behavior or the intention to perform it as the criterion

A theory of how people respond to a warning, built by Rogers in 1975 to explain when a fear appeal actually changes behavior. It splits a person's response into threat appraisal, which is how severe and how likely the danger seems, and coping appraisal, which is whether the recommended action would work (response efficacy) and whether the person can perform it (self-efficacy). The two appraisals together drive the intention to protect oneself. Rogers's threat appraisal is built from the same two beliefs the health belief model calls perceived severity and perceived susceptibility, under a different name and inside a different theory of persuasion. The coping side, in turn, restates the self-efficacy that the health belief model added in 1988, so the two models overlap on almost every component while keeping separate vocabularies.[3]

Unit

A person's appraisal of a health threat and of coping with it

Recovery means

Not applicable

Measured by

Self-report items for perceived severity, vulnerability, response efficacy, and self-efficacy; protective intention as the criterion

Ajzen's 1991 model, an extension of the theory of reasoned action, holds that a behavior follows from the intention to perform it, and that intention is set by three things: the person's attitude toward the behavior, their subjective norm about whether important others approve, and their perceived behavioral control, the sense of how easy or hard the behavior would be. It is one of the most heavily used frameworks in health research, applied to screening, vaccination, diet, and exercise, and it competes directly with the health belief model on the same outcomes. Its perceived behavioral control is close to the self-efficacy that both the health belief model and protection motivation theory rely on, and Ajzen has written that the two are near synonyms. What the model adds beyond threat is a formal path through behavioral intention and an explicit place for social pressure, which the health belief model leaves out.[4]

Unit

A person's intention to act and their perceived control over acting

Recovery means

Not applicable

Measured by

Self-report items for attitude, subjective norm, and perceived behavioral control; intention and later behavior as criteria

The study, in the judgment and decision-making tradition, of how people size up a hazard: how risky it feels, how much dread it carries, and how well understood it seems. Slovic's 1987 psychometric paradigm mapped many hazards along dimensions such as dread and the unknown, and showed that lay judgments of risk follow those qualities rather than expert estimates of expected harm. Perceived risk here is close to what the health belief model splits into perceived susceptibility and severity, and to what protection motivation theory folds into threat appraisal, but it comes from a separate literature with its own measures and its own quarrel with expert probabilities. A study that measures perceived risk and one that measures perceived susceptibility are often asking a person nearly the same question while citing different bodies of work. The paradigm describes how risk is judged and does not by itself say which judgments are accurate.[5]

Unit

A person's judgment of how risky a hazard is

Recovery means

Not applicable

Measured by

Ratings of hazards on qualities such as dread and the unknown, then arranged by psychometric scaling