Friday, 15 May 2015

HEALTHY LIVING - Health belief models

Theories of Health Belief -


The health belief model is a working model that attempts to explain and predict health behaviours by focusing on the attitudes and beliefs of individuals.

The core assumptions of this model is that someone will do a health related action if they believe a negative health condition is avoidable, or of they believe the negative health condition has serious consequences and is worth changing to avoid the negative effects.

If we look at the health belief model above and apply the example of unprotected sex.

An individuals perceptions of susceptibility maybe 'If I have sex unprotected I could get pregnant'
Their perceptions of seriousness maybe 'If I get pregnant I would have to drop out of school'
Demographic variables (age, gender) maybe 'I'm too young, I'm not ready for a child'
Cues to action maybe 'I saw an advert about wearing a condom'
Perceived benefits to action maybe 'If I use a condom I wouldn't get pregnant'
Perceived barriers to action maybe 'Putting a condom on can be embarrassing and it ruins the feeling during sex'

If the benefits of adapting the behaviour outweigh the negative of not, then people will adapt their behaviour.

STUDY: Becker - Compliance with a medical regimen for asthma

Aim: Becker conducted a correlational study to test the health belief model on asthma prevention medication with children.

A sample of 111 mothers with asthmatic children aged between 9 months and 17 years,

The mothers took part in 45 minutes interviews, in which the mothers were asked about how much they used the asthma medication, perceptions of susceptibility and seriousness of the asthma, the interference that asthma has with education, interference with mothers life, effectiveness of medication and faith in doctors. The use of medication was checked by blood tests to check for the medication in the blood.

Positive correlations were found between compliance of medication i.e. taking the medication and; susceptibility to asthma attacks, seriousness of condition i.e. they child could die if medication is not taken, more interference with own activities, more likely to miss out on their education.

Negative correlations were found between compliance of medication i.e. taking the medication and increased issues with accessing chemists, and increased complaints about the medication.

If mothers were married, positive correlation with compliance. If mothers more educated positive correlation with keeping routine prescriptions.

Conclusions: It was concluded that the HBM was accurate in compliance with the medical regimen for asthma.


The locus of control refers to someone’s belief about what causes the good and bad results in their life. The locus of control is a scale from high internal locus of control i.e. the belief that it is the individual is the main cause of their behaviour, actions and situations, to high external locus of control, where the individual will primarily believe that powerful others, fate, or chance strongly determine events, and they are largely out of their control.

Those with high internal locus of control will think that they can influence others and their own lives with their actions; they think that their efforts will be successful, and they are active in seeking information – they will blame themselves both for positive and negative outcomes. Alternatively, those at the other end of the scale will often feel stressed out or overwhelmed, and may be prone to laziness, clinical depression or obesity as they believe what will happen, ultimately will happen.

STUDY: Rotter

A review article study into internal versus external locus of control

Sample: Initially, he used six pieces of research into individual perceptions of ability to control outcomes.

He found that those with an internal locus of control appeared to be more prepared against danger than those with an external locus of control.

Rotter concluded that locus of control would affect many behaviours, including health behaviours, as those with an external locus of control were likely to be less pro-active in avoiding health risks.
He included in his study research by James et al, which found that male smokers who gave up smoking and DID NOT relapse had a higher internal locus of control than those who did not quit.


Self-efficacy refers to a person’s perceptions of their own ability in a particular situation. According to Bandura, someone’s attitudes (including self-efficacy), abilities and cognitive skills comprise what is known as the self-system, which plays a major role in how we perceive different situations, and how we behave in response to these situations.

He described self-efficacy as a determinant of how people think, behave and feel (1994), and demonstrated that self-efficacy impacts everything from psychological states to behaviour, to motivation.

Self-efficacy is believed to begin in early childhood and evolve throughout life. People with a strong sense of self-efficacy tend to view challenges as tasks to be mastered, and recover quickly from setbacks and disappointments, whilst people with a weak sense of self-efficacy avoid challenging tasks, quickly lose confidence, and focus on failures.

Bandura believed that a concept affecting behaviour is the efficacy expectation. This is a persons belief that they can successfully do whatever is required to achieve the outcome.

There are 3 key factors that affect a persons efficacy expectation and you must know these for your 10 mark questions:

  1. vicarious experiences - seeing other people do something successfully 
  2. verbal persuasion - someone telling you that you can do something 
  3. emotional arousal - too much anxiety can reduce a person's self-efficacy
  4. cognitive appraisal - this means that a persons self-efficacy can alter depending on the situation. For example, when public speaking , the time, audience, subject matter and type of presentation may all influence a persons perceived coping capabilities. Self-efficacy is not solely influenced by personality traits.    

STUDY: Bandura and Adams - 

To assess the self-efficacy of patients undergoing systematic desensitisation in relation to their behaviour with snakes.

It was a controlled quasi-experiment

Sample: 10 self-selected patients with snake phobias. There were nine females and one male.

The first part of the procedure was an assessment of the phobia before the behavioural therapy: each patient was assessed for avoidance behaviour towards a snake, efficacy expectations (how well they thought they will be able to perform different behaviours with the snake), their fear of snakes and how effectively they would be able to cope with a snake. These were all measured using a 10 point scale.

They then underwent the behavioural therapy of systematic desensitisation: a standard programme was followed where patients were introduced to a series of events involving snakes and each was taught to relax on each event. These ranged from imagining looking at a picture of a snake to handling a live snake.

After the behavioural therapy: each participant was again measured on behaviours stated above.

The findings showed higher levels self-efficacy shown after the behavioural therapy were found to correlate with higher levels of interaction with snakes. Therefore it was concluded that desensitisation enhanced self-efficacy levels, which in turn led to a belief that the participant was able to cope with the phobic stimulus of a snake.

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