Theories at a glance

¶ … Health Belief Model (HBM) (Becker, 1974) was developed in the1950s by researchers who were seeking to explain why some reject health services such as immunization and screening despite the fact that these services were offered free of charge. HBM, in short, uses a subjective expected utility model of decision evaluation (where the person evaluates and weighs outcomes of expectancies and values). Variables such as the patient's judgment of high susceptibility to disease, high severity of disease, high benefit in regards to using service, and low barriers involved in using the service would configure in the decision-making model regarding whether or not to adopt a possible course of health action.

One of the oldest yet one of the most widely accepted beliefs on health behavior, HBM posited that six main constructs influence people to care for their health and/or to seek medical intervention when necessary. These six constructs are the following: perceived susceptibility to the disease condition; perceived severity of the disease condition; perceived benefits to acting in a preventative or curative manner; perceived costs of acting; cue to action (i.e. individuals are exposed to cues (such as material) that impels action); and self-efficacy (i.e. individuals feel empowered to act).

HBM can be used to explain examples of preventive action such as where individuals rigorously maintain a diet and/or exercise routine. These individuals generally incorporate their susceptibility to disease, realize the benefits of acting, and possess the self-efficacy to take preventative action. Another example where HBM is a good fit is by high-risk sexual behavior where the same constructs apply.

Practitioners find the six constructs of the HBM a useful framework for planning and designing interventions for both short-term and long-term change. These concepts are merged with the following instances: specifying the nature of the disease (I.e. ramifications to health if exercise is averted), offering assistance (in the case, for instance, of implementing a diet); and self-efficacy (via programs that provide training and guidance).

2. Self-Efficacy Theory (SET; Bandura, 1986), otherwise called Social Cognitive Theory (SCT). SET or SCT believes that the two key determinants of behavior are perceived self-efficacy and outcome expectancies. In other words, the extent to which the person feels able to actualize / implement behavior, and the consequences (both negative and positive) of performing the behavior. SCT is actually an extension of SET in that it maintains that the environmental factors as well as human factors are all intertwined in determining self-efficacy; in fact that the three concepts play one inseparable whole in determining health conduct and response to prevention or to reaction of disease.

The three main factors that induce a person to change his health behavior are the following: (i) self-efficacy, (ii) goals, and (iii) outcome expectations.

Individuals who have a powerful sense of self-efficacy can change health behaviors even when impeded. It is this very sense of empowerment -- of feeling ability to act and to change matters -- that propels them past inertia and causes them to persist despite challenges. The adoption of new behavior, in turn, causes changes in the environment and in the person.

Behaviorism believed that the person was a product of the environment. Sociology, for instance, believes that the environment is a product of the person. SCT, integrating cognitive, emotional, and behavioral aspects, asserts a fusion of cognition, behavior, and environment whereby, through individual changes, a person can change his environment that, in turn, affects his behavior.