Theories of Health Belief

Health belief model (HBM)

There are two main aspects, the perceived seriousness (Will it actually kill me?) and the perceived susceptibility (Am I likely to get it?). In addition there’s also the cost-benefit analysis (Do the benefits outweigh the costs?), demographic variables such as age and gender and external cues such as television advertisements and posters or internal cues such as a period of ill health which might remind us about the behaviour. Therefore if a person perceives a threat to their health they will adopt healthy behaviour.

Becker, Compliance with a medical regimen for asthma

• Aim: Use HBM model to explain mother’s adherence to a drug regimen for their asthmatic children.
• Methodology:
  • ​Correlation design.
  • Some participants had a blood test, confirming the adherence.
  • 111 mothers.
  • Each mother interviewed for 45mins.
• Findings:
  • ​Positive correlation between mother’s belief about child’s susceptibility to asthma attacks.
  • Mothers were more likely to comply, the greater the mother’s education and if married, the more likely she would be to keep to the prescribed routine for administering the medication.
• Conclusion: The HBM is a useful model to predict and explain different levels of compliance with medical regimes.
• Evaluation:
  • ​Biased sample, not representative of the general population, e.g. only using mothers who normally have a more caring behaviour than fathers.
  • High in ecological validity as the children already had asthma.
  • Leading questions in the interview could have lead to biased answers.
  • High in validity due to blood tests confirming adherence.

Locus of control

• Internal locus of control: individual controls their health themselves.
• External locus of control: seeing their health as being in someone else’s hands (e.g. doctors or parents).

Rotter, Internal versus external locus of control

• Findings: Participants with an internal locus of control were more likely to show behaviours that would enable them to cope with potential threats, than participants who thought that chance determined the effects of their behaviours.
• Conclusion: Locus of control would affect many of our behaviours, not just health behaviour.
• Evaluation:
  • ​Reductionist, it reduces the explanation for why people do/don't adopt healthy life styles down to just two variables (internal/exter LOC). E.g. whether an individual adopts a healthy lifestyle is probably dependent on a wide number of variables, not just locus of control.
  • Low in validity due to the use of a review article.

Self-efficacy

This is our belief about how we can perform in particular situations, and our competence about this will affect our attitudes, cognitions and behaviours. In relation to health, if we believe that we are able to act successfully then we are more likely to put effort into an action because we believe it will be successful. On the other hand, if we do not believe we will be successful then we believe that here is no point in trying.

Bandura and Adams, Analysis of self-efficacy theory of behavioural change

• Findings: Higher levels of post-test self-efficacy were found to correlate with higher levels of interaction with snakes.
• Conclusion: Systematic desensitisation enhanced self-efficacy levels, which in turn led to a belief that the participant were able to cope with the phobic stimulus of a snake.
• Evaluation:
  • ​All three theories can be accused of being reductionist because it ignores other key influences on behaviour. E.g. Behavioural factors such as social learning.
  • Natural experiment therefore cause and effect cannot be established so whether the naturally occurring independent variable had an effect on the dependent variable.
  • Only 10 participants therefore this cannot be representative of the general population also as only one male participant was used it could be said that females generally have more phobias.
  • Also they had replied to a newspaper ad potentially meaning that they had time on there hands and this could of lead to the outcome of biased answers