Chapter 13: Chapter 13: Health Belief Model, Health Belief Model, Protection Motivation Theory, and Physical Protection Motivation Theory, and Physical

ActivityActivity

Health Belief Model Health Belief Model (HBM) (HBM)

One of the first models that adapted One of the first models that adapted theory from the behavioral sciences to theory from the behavioral sciences to health problemshealth problems

Most widely recognized conceptual Most widely recognized conceptual framework for health behaviorframework for health behavior

Developed to ________________ that Developed to ________________ that prevent unwanted adverse conditionsprevent unwanted adverse conditions

For an individual to take action to avoid For an individual to take action to avoid an unwanted health outcome, he/she an unwanted health outcome, he/she must feel …must feel …

• Personally susceptiblePersonally susceptible• Disease will have at least moderate severity Disease will have at least moderate severity

on some component of lifeon some component of life• By taking action, severity or susceptibility By taking action, severity or susceptibility

will be reducedwill be reduced• Perceived benefits of doing the behavior will Perceived benefits of doing the behavior will

outweigh the perceived barriersoutweigh the perceived barriers

Assumptions of the HBM Assumptions of the HBM

Constructs of Health Belief Model

• Perceived ____________

• Perceived ____________

• Perceived ____________

• Perceived _____________

• Cues to Action

• Self-Efficacy

Perceived ThreatPerceived Threat

Individual Individual

PerceptionsPerceptions

Perceived Perceived SeveritySeverity

Perceived Perceived SusceptibilitySusceptibility

Modifying FactorsModifying Factors

Demographic Demographic FactorsFactors

Cues to ActionCues to Action

Likelihood of ActionLikelihood of ActionBenefits of Action

MinusBarriers to Action

Likelihood Likelihood of of

ActionAction

Self-EfficacySelf-Efficacy

Likelihood Likelihood of of

Action?Action?

Individual Individual PerceptionsPerceptions

•Perceived ______________ _______________ the disease

•Perceived _____________ of disease in terms of contraction or non-treatment

Perceived SeverityPerceived Severity

Perceived Perceived SusceptibilitySusceptibility Perceived ThreatPerceived Threat

Perceived ThreatPerceived Threat

Individual Individual

PerceptionsPerceptions

Perceived Perceived SeveritySeverity

Perceived Perceived SusceptibilitySusceptibility

Modifying FactorsModifying Factors

Demographic Demographic FactorsFactors

Cues to ActionCues to Action

Likelihood of ActionLikelihood of ActionBenefits of ActionBenefits of Action

MinusMinus

Barriers to ActionBarriers to Action

Likelihood Likelihood of of

ActionAction

Self-EfficacySelf-Efficacy

Perceived ThreatPerceived Threat

Individual Individual

PerceptionsPerceptions

Perceived Perceived SeveritySeverity

Perceived Perceived SusceptibilitySusceptibility

Modifying FactorsModifying Factors

Demographic Demographic FactorsFactors

Cues to ActionCues to Action

Likelihood of ActionLikelihood of Action

Benefits of ActionBenefits of ActionMinusMinus

Barriers to ActionBarriers to Action

Likelihood Likelihood of of

ActionAction

Self-EfficacySelf-Efficacy

Perceived ThreatPerceived Threat

Individual Individual

PerceptionsPerceptions

Perceived Perceived SeveritySeverity

Perceived Perceived SusceptibilitySusceptibility

Modifying FactorsModifying Factors

Demographic Demographic FactorsFactors

Cues to ActionCues to Action

Likelihood of ActionLikelihood of Action

Benefits of ActionBenefits of ActionMinusMinus

Barriers to ActionBarriers to Action

Likelihood Likelihood of of

ActionAction

Self-EfficacySelf-Efficacy

•Mass media

Advice from others Family illness

Slenker and her colleagues (1984) Slenker and her colleagues (1984) examined the utility of the HBM for examined the utility of the HBM for distinguishing joggers from non-distinguishing joggers from non-exercisersexercisers

• Joggers = 3 times/wk for twenty minutesJoggers = 3 times/wk for twenty minutes • Non-exerciser = had not exercised regularly Non-exerciser = had not exercised regularly

for the past six monthsfor the past six months • Joggers=greater perception of severity, more Joggers=greater perception of severity, more

benefits of and cues to jogging, and less benefits of and cues to jogging, and less barriers to jogbarriers to jog

• Perceived __________________ did not Perceived __________________ did not distinguish joggers and non-exercisers.distinguish joggers and non-exercisers.

HBM and Physical ActivityHBM and Physical Activity

Desmond et al. (1990) assessed …Desmond et al. (1990) assessed …• Exercise knowledge Exercise knowledge • Cues to action Cues to action • Perceived severity of health risks Perceived severity of health risks • Perceived susceptibility to health risksPerceived susceptibility to health risks• Benefits of exercise Benefits of exercise • Barriers to exerciseBarriers to exercise

154 Black and 93 White fit and unfit 154 Black and 93 White fit and unfit adolescents.adolescents.

HBM and Physical ActivityHBM and Physical Activity

Unfit (vs. fit) black students …. Unfit (vs. fit) black students ….

• Rated health problems from no exercise as Rated health problems from no exercise as more severe more severe

Unfit (vs. fit) white students …. Unfit (vs. fit) white students ….

• Rated susceptibility to health problems as Rated susceptibility to health problems as greatergreater

Both contrary to health belief modelBoth contrary to health belief model

HBM and Physical ActivityHBM and Physical Activity

Godin & Shephard (1990) carried Godin & Shephard (1990) carried out a narrative review out a narrative review

Found no clear support for model in Found no clear support for model in physical activityphysical activity

Why Not? Why Not?

Is Health Belief Model Valid for Is Health Belief Model Valid for Prediction of Exercise Behavior?Prediction of Exercise Behavior?

Limitations of the Health Belief Model…Limitations of the Health Belief Model…

_________________ as the primary _________________ as the primary driving force behind exercise driving force behind exercise behavior.behavior.

Developed to predict a single Developed to predict a single instance of a specific behavior instance of a specific behavior acute (not chronic)acute (not chronic)

Protection Motivation Theory Protection Motivation Theory

DevelopedDeveloped to explain inconsistencies to explain inconsistencies in research on fear appeals and in research on fear appeals and attitude changeattitude change

Concerned with the decision to Concerned with the decision to protect oneself from harmful or protect oneself from harmful or stressful life eventsstressful life events

May also be viewed as a theory of May also be viewed as a theory of copingcoping

Protection Motivation Theory Protection Motivation Theory

Decisions to engage (or not engage) Decisions to engage (or not engage) in health-related behaviors based in health-related behaviors based on:on:• __________ appraisal __________ appraisal • ___________appraisal ___________appraisal • Common index of protection Common index of protection

motivation is a measure of motivation is a measure of ____________________________

Threat Appraisals:

Vulnerability

Severity

Coping Appraisals:

Self-Efficacy

Response efficacy

Intentions Behavior

Protection Motivation Theory Protection Motivation Theory Threat appraisalThreat appraisal::

• An evaluation of the factors that influence the An evaluation of the factors that influence the likelihood of engaging in a potentially unhealthy likelihood of engaging in a potentially unhealthy behavior behavior

• ____________________________________________________--estimate of the --estimate of the degree of personal risk for a specific health hazard degree of personal risk for a specific health hazard if a current unhealthy behaviors is continued if a current unhealthy behaviors is continued

• __________________________________________________--estimate of the --estimate of the threat of the disease threat of the disease

• Continuation of unhealthy behavior is increased Continuation of unhealthy behavior is increased by the perceived intrinsic and extrinsic rewards of by the perceived intrinsic and extrinsic rewards of the unhealthy behaviorthe unhealthy behavior

Protection Motivation Theory Protection Motivation Theory Coping appraisalCoping appraisal::

• ____________________________________________--expectancy --expectancy that complying with recommendations that complying with recommendations will remove the threat will remove the threat

• ____________________________________________--belief in --belief in one’s ability to implement the one’s ability to implement the recommended coping behavior or recommended coping behavior or strategy strategy

• The likelihood of carrying out the The likelihood of carrying out the preventive coping response is preventive coping response is decreased by the perceived costs of decreased by the perceived costs of completing the health behavior completing the health behavior

Protection Motivation Theory Protection Motivation Theory AssumptionsAssumptions

Motivation to implement the coping Motivation to implement the coping response is at its maximum when response is at its maximum when the individual perceives the individual perceives ::• The threat is ___________The threat is ___________• He or she is personally ____________ He or she is personally ____________

to the threat to the threat • The _________________ is effective to The _________________ is effective to

avert the threat avert the threat • He or she has the _________________ He or she has the _________________

the coping response the coping response

Protection Motivation Theory ResearchProtection Motivation Theory Research

Meta-analysis carried out by Floyd and Meta-analysis carried out by Floyd and her colleagues (2000) her colleagues (2000)

65 studies with 29,650 participants65 studies with 29,650 participants

Adaptive intentions and behaviors Adaptive intentions and behaviors were moderately facilitated bywere moderately facilitated by::• increases in threat severity increases in threat severity • threat vulnerability threat vulnerability • response efficacy response efficacy • self-efficacy self-efficacy

Protection Motivation and Physical Protection Motivation and Physical ActivityActivity

Plotnikoff and Higginbotham (1998) examined Plotnikoff and Higginbotham (1998) examined the prediction of diet and physical activity to the prediction of diet and physical activity to prevent further cardiovascular heart disease prevent further cardiovascular heart disease in 151 recent heart attack patientsin 151 recent heart attack patients• Completed baseline measures of threat Completed baseline measures of threat

appraisal following a heart attack appraisal following a heart attack • Six months later completed measures of threat Six months later completed measures of threat

appraisal and coping appraisal appraisal and coping appraisal • Self-efficacy was the strongest predictor of Self-efficacy was the strongest predictor of

exercise and diet intentions and behaviorsexercise and diet intentions and behaviors• Concluded that health education for this Concluded that health education for this

population should promote self-efficacy population should promote self-efficacy enhancing activities for such behaviorsenhancing activities for such behaviors

Protection Motivation and Physical Protection Motivation and Physical ActivityActivity

Courneya (1995) compared perceptions of Courneya (1995) compared perceptions of the severity of a sedentary lifestyle among the severity of a sedentary lifestyle among 270 senior citizens who were classified 270 senior citizens who were classified within one of the five stages of the within one of the five stages of the Transtheoretical Model. Transtheoretical Model. • PrecontemplationPrecontemplation• ContemplationContemplation• PreparationPreparation• ActionAction• Maintenance Maintenance

Protection Motivation and Physical Protection Motivation and Physical ActivityActivity

Found:Found:• Precontemplation stage reported the Precontemplation stage reported the

least perceived severity of the least perceived severity of the consequences of an inactive lifestyle consequences of an inactive lifestyle

Concluded that the main function of Concluded that the main function of perceived severity of physical perceived severity of physical inactivity is to motivate people to inactivity is to motivate people to seriously consider becoming seriously consider becoming physically activephysically active

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