¶ … Health belief model During the 1950's, the Health Belief model (HBM) was developed from the field of social psychology. The theoretical framework offers an explanation of why individuals are motivated to participate in preventive health behaviors. The model has five perception constructs of susceptibility, severity, benefits, barriers, and cues to action. In this setting the HBM predicts what prevention behaviors diabetic patients will engage in to avoid foot pathology and ultimately amputation. Current research indicates that the Health Belief Model (HBM) is the most common model used to study health- related behaviors. According to Ganz, Rimer, and Lewis (2002) an assumption of this model indicates people are more inclined to demonstrate disease prevention activities when they perceive (a) an increased susceptibility to the illness; (b) the illness is severe; (c) the actions are valuable; (d) the behavior has few obstacles; and (e) are prompted to execute the actions.

The application of the Health Belief Model to examine the rates of influenza vaccines in connection with a sense of vulnerability found that "it is more likely for vaccination to correlate positively with perceived susceptibility" (Chen, Wang, Schneider, Tsai, Jiang, & Lin, 2011). In addition, the model has been applicable in identifying factors influencing the underutilization of mental health service related to "perceptions of symptoms and vulnerabilities, views of the value of mental health care, the nature and severity of related barriers, and beliefs that one might be able to make effective use of mental health interventions" (Smith, 2009). Lastly, Mahmoodi et al. (2011) found that "education aimed at improving men's participation in family planning may enhance the individuals 'awareness and attitude, thus contributing to family health" with the use of the health belief model.

Health Belief Model

Health Belief Model (HBM) was created in the 1950s by a team of U.S. public Health social psychologists who sought to explain why so few people were participating in available government-benefit health programs.

Their research led them to believe that the following four factors would drive a person to take better and more earnest care in her health:

1 The person's perception of severity of a certain illness

1. The person's perception of his/her vulnerability to that illness

1. The barriers to taking action to heal himself

1. The benefits of taking that particular action to prevent illness / heal himself.

HBM has become a popular model in nursing and social work particularly in America since it provides a way of making health programs more attractive to intended users. HBM, in fact, remains one of the most popular health models of nursing on both a global and national scale and is used to address problems that evoke health concerns, such as those of high-risk sexual behavior, and the possible of contracting AIDS (Croyle, 2005).

The entire model, in short, hinges on a person's perception towards a certain illness -- his chance of incurring it and the benefits of his taking action. Perception, in other words, drives motive.

HBM has six key principles:

1. Perceived Susceptibility -- person's perception that he is susceptible to disease

2. Perceived severity -- person will only take action if he considers disease to be sufficiently severe or have high social consequences

3. Perceived benefits -- person will take action if she considers action potentially beneficial

4. Perceived costs -- person will cease to take action if she considers costs (not only economic) too steep

5. Motivation -- the desire to comply with the treatment

6. Enabling or modifying factors -- these include personality variables, patient satisfaction, and socio-demographic factors.

Health Belief Model and Nursing

The health model is similar to nursing since deals with preventing and curing disease, and the Health model serves the same purpose.

Curing disease is a costly project and much time, cost, and suffering can be eliminated if people would only learn to prevent their own disease. This is where the HBM comes into play. It is invaluable in that it provides insight as to possible cognitive / psychosocial mechanisms that impede patients from taking the necessary preemptive actions. In this way, it is supplementary to nursing; nurses use it as an aid to understanding and encouraging patients thereby improving their practice. It is also supplementary to nursing in a theoretical sense. Nursing focuses on the practicum. Nonetheless, nurse can sometime become frustrated. They may treat patients and warn them of preventative measures and patients -- at conscious risk to their lives -- continue to ignore their injunctions. Nurses, therefore, need to understand the rationalizations and mental impediments of their patients in order to most effectively ensure...

This is where HBM comes in useful. Understanding the way that people think in regards to health can help practitioners formulate and structure health programs that will better attract people to using them.
Nurses by employing HBM may, for instance, make a specific program more attractive by attempting to uncover the patient's current perception of the program and/or his or her perspective of his susceptibility to the disease and his mindset of the disease, its social ramification, and the costs of the program. There are some cultures that may welcome a certain disease considering it normal, or may consider certain medical concerns (such as smoking) to be unwarranted. Understanding the cultural perspective and dealing with the patient within that context can help nurses better understand patient and help him in preventing and curing disease.

Application of the Health Belief Model

The HBM seems to have been used all across the board: from understanding why people do not use helmets when bicycling, to encouraging sunscreen use, to investigating cervical cancer, obesity, perceived barriers to children's healthy eating, osteoporosis, breast cancer screening, factors influencing cancer risk and procrastination with treatment and so forth. Issues congruent to both gender and to m any cultures are also liberally discussed. It is difficult to think of any issue or any sector that studies using HBM have ignored. There seems to be no gap.

One of the contemporary growing health problems on which the HBM was used investigating patients' inclination towards eating disorders despite the huge mortality rate of that disease. 34 men and women living with eating disorders were, consequently, recruited and interviewed regarding their experiences with managing their disorders, including reasons why they decided to forego treatment or social support in helping them deal with the disease.

The participants' responses were then framed against the five main constructs of the Health Belief Model which were: (a) perceived susceptibility to a health threat, (b) perceived severity of the health threat, (c) perceived benefit of protective health behaviors, (d) perceived self-efficacy with these protective behaviors, and (e) perceived barriers to performing these behaviors.

The researchers argued that understanding why patients refuse to eat or refuse to accept treatment cannot only help medical practitioners treat these particular patients but can be also used to inform relevant therapeutic interventions. (Akeye, 2012)

In 2011, another study (Chen et al., 2011) applied the Health Belief Model to investigate why some caregivers decided to vaccinate their children for influenza. A Cross-sectional study was employed of 2,778 useable responses to surveys of 33 public health centers and 40 medical institutions who participated in vaccination programs in southern Taiwan. Results showed that the factors that most influence decision included age, current employment, and residence of the caregiver as well as chronic disease, hospitalization, and influenza histories of the child. Predictors revealed by the Health Belief Model were perceived susceptibility of the children to influenza, perceived benefits of vaccinations to children, perceived barriers to vaccinations, and intention to action. The researchers found the HBM useful in that they concluded that results of their study could be used to develop strategies for encouraging more caregivers to vaccinate their children against influence.

The importance of community partnership in community health projects.

1. For success and acceptance of health projects, the community needs to be involved. An example was given above with certain cultures that may welcome a certain disease considering it normal, or may consider certain medical concerns (such as smoking) to be unwarranted. Understanding the cultural perspective and dealing with the patient within that context can help nurses better understand patient and help him in preventing and curing disease, but understanding and insight is insufficient. The patient may still refuse to be helped or not understand treatment as long as his culture persists in repudiating treatment or in dismissing the disease as being disease. An example may be found in Fadmina's (1997) book The Spirit Catches You and You Fall Down where Hmong parents desisted in curing their child of epileptic fits since epilepsy in their cultorue was considered a gift from the gods. Two doctors, in particular, attempted to help the parents and develop more empathy with their Hmong lifestyle. Yet the parents and community only developed and intensified their mistrust for the very defend practices of the medical institution and refused to follow the prescribed treatment at times, deliberately hijacking it. The result was the decline of the child into vegetation and her consequent death, and rancor amongst the Hmong community and the doctors. The child need not have died if the community would…