13.4: Health Belief Model
The Health Belief Model (HBM) was actually proposed by researchers working for the U.S. Public Health Service in the 1950s, who were attempting to explain why some people might not opt for health screenings (such as a tuberculosis test) or vaccinations (such as those for polio), especially if these were offered at little to no cost (Rosenstock, 1974). This model asserts that in order for a person to take action, they must have certain beliefs, including:
- That the consequences of not taking action are severe,
- That the person themselves is susceptible,
- And that the perceived benefits outweigh the perceived costs of taking action.
There also need to be cues in the environment that prompt the person to take action. Subsequent applications of the HBM to more complex behaviors highlighted the importance of including self-efficacy in this process as well (McKenzie et al., 2017). Self-efficacy is the belief that a person has about their own abilities to take a specific action. Thus, a lack of self-efficacy could be considered a substantial perceived barrier in this model (McKenzie et al., 2017). See Fig. \(\PageIndex{1}\) below for a diagram of the HBM.
Both the TPB and the HBM are intrapersonal models, meaning they focus mostly on what the individual thinks, believes, and decides about the behavior themselves. The TPB certainly recognizes the influence of social norms, and the HBM perhaps implicitly includes some environmental aspects into the perceived barriers and benefits, yet these models may not fully explain how a person develops beliefs or self-efficacy. The next model attempts to do just that.