Transcript L4_HBM

Health Belief Model
PHCL 436
Outline
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Introduction.
Model constructs.
Relationship among model constructs.
Limitations.
Applications.
Introduction
• 1950s. Studying why individuals did or did not
participate in screening programs for
tuberculosis.
• Studies to assess this model provided support
to this model.
• Focus on two: Perceived benefits and threats.
HBM Constructs
• Perceived susceptibility
• Perceived severity
• Perceived benefits
• Perceived barriers
• Cues to action
• Self-efficacy
Perceived susceptibility
• The person’s perception of the risk of getting a
health condition.
Perceived severity
• Person’s belief about the seriousness of the
disease.
Perceived benefits
• Person’s belief about the benefits of this
specific action (for example taking
medication).
Perceived barriers
• Related to person’s belief about barriers of
taking the action.
Cues to action
• Different methods and strategies used to
activate and trigger the person to take action.
Self-efficacy
• How the person confident of ability to take
the action to take care of the health condition.
Figure 1. The relationship between the components of the HBM and behavior
change
Individual Perceptions
Perceived
susceptibility to,
severity of disease
Modifying Factors
Likelihood of action
Age, sex, ethnicity
Personality
Socioeconomics
Knowledge
Perceived benefits minus
perceived barriers to
behavior change
Perceived threat
of disease
Cues to action
Education
Symptoms
Media
Likelihood of
behavior change
Comments
• Research:
– Use multiple item for each scale to reduce errors.
– Validity and reliability for various setting.
• Limitations:
– Not considering emotion. E.g. Fear.
Example discussion
Application
• Behavioral Factors Predict Adherence to LipidLowering Medications.
• Factors for non-adherence:
– The asymptomatic nature of dyslipidemia,
– Adverse effects of medications,
– Cost related to treatment.
Example
• Perceived susceptibility: The person’s
perception of the risk of getting a health
condition.
• In patients with dyslipidemia?
Dyslipidemia
• It is the person’s perception of the risk of
getting a CAD event.
• It is usually minimized especially for those
patients in their 30s or 40s as they think
getting CAD event is unlikely.
Example
• Perceived severity: Person’s belief about the
seriousness of hyperlipdemia.
• In dyslipidemia?
Dyslipidemia
• It is asymptomatic disease, patients may not
consider it as a serious condition.
• Except for patients who already developed
heart attack.
Example
• Perceived benefits: Person’s belief about the
benefits of this specific action (for example
taking medication).
• With lipid-lowering medications?
Dyslipidemia
• With lipid-lowering medications patients may
not notice any changes in symptoms or
reduction in hospitalization.
• To increase the awareness of benefits of lipidlowering medications:
– Feedback to patient about progress of treatment
and changes in lipid levels.
Example
• Perceived barriers: Related to person’s belief
about barriers of taking the action.
• Barriers in dysplipidemia?
Dyslipidemia
• Barriers of using lipid-lowering medications
include adverse effects, financial, complex
regimen, and other patients concerns.
Example
• Cues to action: Different methods and
strategies used to activate and trigger the
person to take action.
• Triggers to adhere to lipid-lowering
medications?
Triggers
• Heart attack
• Good communication and feedback on lipid
levels
• Reminders
Example
• Self-efficacy: How the person confident of
ability to take the action to take care of the
health condition.
• In hyperlipidemia it is the person’s confident
of ability to take their lipid-lowering
medications as prescribed.
Quiz