diagrammatic representation of health belief model

What Is the Health Belief Model? An Updated Look

Despite this fact, participation in screening tends to be low. In Australia, only 40% of adults opted for screening for bowel cancer in 2021 — 3% lower than the previous year (Australian Institute of Health and Welfare, 2023).

Why do people decide not to participate in a low-risk activity like screening? Or visit the dentist regularly, or quit smoking? Why do we choose to ignore these necessary health steps?

Why and how people view the risks of disease, and the subsequent likelihood of people adjusting their behaviors, can be better understood with the health belief model.

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This Article Contains

A brief history of the health belief model, primary components of the health belief model theory, 3+ health belief model application examples, updates and modifications to the hbm, criticisms of the hbm, 6 worksheets and interventions, a take-home message.

Researchers knew that socioeconomic, sociocultural, and demographic factors, such as age, gender, ethnicity, and race, influenced the likelihood that people could afford health care and would seek it out (Abraham & Sheeran, 2015). However, what researchers observed in the 1950s surprised them.

In the 1950s, screening for tuberculosis was made easier and more accessible with mobile X-ray vans, removing the need for patients to make costly and time-consuming trips to hospitals and clinics. What social psychologists Hochbaum, Rosenstock, and Kegels observed was surprising: Despite the increased accessibility and convenience, there was meager participation (Daniati et al., 2021; Skinner et al., 2015). Why would this be?

These researchers posited that patients’ beliefs, attitudes, and understanding of the illness and health care greatly influenced the likelihood that they would seek preventive treatments and screening (Janz & Becker, 1984). This hypothesis resulted in the health belief model (HBM).

The HBM consisted of the following five concepts:

• Perceived susceptibility describes the individual’s belief about the likelihood of getting a particular health condition.
• Perceived severity refers to the individual’s belief about the seriousness of the health condition and its consequences.
• Perceived benefits describe the belief in the effectiveness of taking action to reduce risk or seriousness of the health condition.
• Perceived barriers refer to the perceived obstacles or costs associated with taking action to reduce the risk or seriousness of a health condition.
• Cues to action are triggers that prompt individuals to take action, such as symptoms, media campaigns, or recommendations from health care providers.

The health belief model was later modified to include additional factors. These are self-efficacy, our belief in our ability to take action, and the importance of socio-demographic factors.

Here is a short video that uses a simple example to explain the HBM.

Although the original use case of the HBM was to explain low participation in preventive screening programs for diseases, it has since been applied to other scenarios. These include smoking cessation treatments, vaccination programs, and treatment adherence.

These components explain how individuals gauge the threat of behaviors and illnesses and interpret and value the efficacy of treatment, ultimately shaping their decision to adopt health-promoting behaviors (Abraham & Sheeran, 2015).

We will go through each component in more detail below.

1. Perceived susceptibility

Perceived susceptibility refers to how an individual’s belief in their vulnerability to a specific disease can lead to preventive actions and behaviors. For example, people who believe they are at severe risk of contracting the flu are more likely to opt for a flu vaccine.

2. Perceived severity

People are more likely to engage in behaviors to mitigate health issues when they perceive a health issue as serious and think that it might impact their lives. This is known as perceived severity . For example, knowing the risks of smoking-related diseases can encourage quitting.

3. Perceived benefits

Perceived benefits describe how individuals are also more likely to engage in certain behaviors if they positively perceive the benefits of those behaviors. For example, people who perceive the benefits of regular exercise positively are more likely to exercise than people who undervalue or do not recognize the benefits of exercise.

4. Perceived barriers

Perceived barriers refer to the severity and difficulty of obstacles/barriers that can significantly impact whether individuals are likely to adopt certain behaviors. If people have to overcome many obstacles to achieve a particular goal, they are less likely to adopt and maintain the behavior.

These obstacles can be practical, psychological, or social and can include cost, inconvenience, fear, or a lack of social support. More examples of barriers include the cost of a gym membership, clinic location, the psychological effort to complete a task, or the time needed to exercise.

5. Cues to action

The fifth component, cues to action , prompts individuals to take action regarding their health. These cues can be internal, such as personal experiences, or external, such as advice from health care providers.

These cues influence health-related decision-making and actions by closing the gap between awareness of health risks and the initiation of appropriate health behaviors. For example, people know when to seek out a health care professional if they can identify symptoms of certain illnesses.

6. Self-efficacy

Self-efficacy is the sixth component added to later adaptations of the health belief model. Self-efficacy is our belief in our ability to perform healthy behaviors successfully. Higher levels of self-efficacy are associated with greater motivation and persistence in adopting and maintaining health-promoting behaviors.

Examples of self-efficacy are trusting in our ability to succeed and recognizing that we have the skill set and knowledge to overcome challenges.

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The health belief model can be applied to several health-related contexts to explain behavior and participation (Abraham & Sheeran, 2015).

Some examples include:

• Programs that tackle preventive behaviors, such as screening, risk behaviors, vaccinations, and contraceptive behaviors
• Adherence programs for the treatment of various illnesses
• Clinic visits

We will briefly look at a few of these applications in more detail.

Smoking cessation programs

To measure knowledge and perception of health behaviors related to smoking cessation, health educators and practitioners used questionnaires measuring various components of the HBM (Renuka & Pushpanjali, 2014). The aim of the study was to determine whether attitudes, behaviors, and knowledge of tobacco use could change through health care education.

This study was specifically conducted in dental care settings due to the relationship between tobacco use and dental health. Tobacco use is correlated with various dental illnesses and conditions, including dental cancer and cleft lip and palate (Renuka & Pushpanjali, 2014).

Results of the study showed that health behavior and knowledge around tobacco and smoking behaviors improved overall. Dental behavior also significantly improved, but only for younger participants, participants who smoked tobacco products (as opposed to vaping), and individuals who already visited the dentist at least once per year. So improvement in these three domains reduces the risk of oral diseases associated with smoking.

Cancer screening campaigns

Research has shown that incorporating HBM components into cancer screening campaigns is compelling and informative. For example, Luquis and Kensinger (2019) found that two components of the health belief model — perceived susceptibility and perceived seriousness — significantly predicted whether younger adults were likely to regularly screen for various cancers.

Vaccination campaigns

Previous studies have found a significant correlation between several components of the HBM and vaccination hesitancy. A systematic review of 16 studies with over 30,000 participants found that vaccine hesitancy was linked to perceived barriers in a positive way (Limbu et al., 2022).

On the other hand, vaccine hesitancy was linked to perceived benefits, perceived susceptibility, cues to action, perceived severity, and self-efficacy in a negative way (Limbu et al., 2022). These results confirm previous findings in the literature (e.g., Mercadante & Law, 2021).

With this insight, health authorities and organizations can use the HBM to encourage vaccination uptake by addressing:

• Individuals’ perceptions of susceptibility to vaccine-preventable diseases
• The severity of those diseases
• The benefits of vaccination for personal and community health
• Strategies to overcome vaccine-related barriers, such as vaccine hesitancy and misinformation

Other areas where the health belief model has been successfully applied include:

• Diabetes (Gillibrand & Stevenson, 2006; Sharifirad et al., 2006)
• Exercise (King et al., 2013)

Interestingly, applying the HBM outside the medical domain has had less success. For example, research suggests that the HBM has limited predictive value in explaining and improving seat belt usage (Şimşekoğlu & Lajunen, 2008; Tavafian et al., 2011).

These examples illustrate how the health belief model can inform the development and implementation of health promotion initiatives across various health issues.

Some of these updates and modifications include the following.

Inclusion of additional constructs

One significant modification involves the inclusion of additional constructs beyond the original components of the HBM. For example, self-efficacy, which refers to an individual’s belief in their ability to perform a specific behavior successfully, was incorporated into the model following research by King (1982, as cited in Abraham & Sheeran, 2015).

King argued that self-efficacy was an excellent predictor of patients attending hypertension screening (King, 1982, as cited in Abraham & Sheeran, 2015). Over time, this concept merged with research into locus of control and perceived control and became known as self-efficacy.

Integration with social cognitive theory

The efficacy of the health belief model is improved when used alongside other theories. One such example is the social cognitive theory (SCT).

Social cognitive theory emphasizes the role of observational learning, social influence, and self-regulation in shaping health behaviors (Abraham & Sheeran, 2015).

Integrating SCT with the HBM provides a more comprehensive understanding of how individuals’ beliefs, social environment, and self-efficacy influence health-related decisions and actions.

Incorporation of technology

With the advancement of technology, researchers and practitioners have explored the use of digital platforms, mobile apps, and online interventions to apply the principles of the health belief model in promoting health behaviors.

These technology-based interventions leverage interactive features, personalized feedback, and social support to enhance individuals’ motivation, self-efficacy, and engagement in health-promoting activities (Kim & Park, 2012).

Additionally, when paired with the technology acceptance model to measure the perceived usefulness of the internet for health information and attitudes toward internet use for health purposes, the positive effects of the HBM are amplified and the model is strengthened (Ahadzadeh et al., 2015).

Overall, the updates and modifications to the health belief model reflect efforts to enhance its theoretical robustness, practical utility, and cultural relevance in promoting health behavior change across diverse populations and settings.

Initial criticism of the model focused on the poorly defined constructs underpinning the HBM and its poor predictive statistical power (Armitage & Conner, 2000).

Although changes have been made, not all researchers and authors agree about the improvements and modifications made to the health belief model.

Some of the controversies associated with the improvements and modifications include theoretical disagreements about the underlying constructs that compose the model. Also, there is substantial overlap between models explaining health behavior, such as the health belief model and another theory, protection motivation theory (Abraham & Sheeran, 2015).

Other criticisms include the fact that the HBM largely ignores structural barriers. For example, changing attitudes and beliefs about health care does little to combat the cost of health care treatment (Wong et al., 2020).

Despite these controversies and challenges, the health belief model remains a valuable framework for understanding and promoting health behavior change.

Researchers continue to explore its applications, refine its constructs, and evaluate its effectiveness in diverse contexts. The debates surrounding the HBM contribute to ongoing discussions within health psychology and public health, fostering critical reflection and innovation in theory and practice.

Health belief model scale

Various HBM scales exist, and the difference between them is their application, because the scales measure beliefs and attitudes around a disease, behavior, treatment, or intervention of interest.

For practitioners interested in using questions from a health belief model scale to measure clients’ attitudes toward a particular treatment or behavior, they will need to adapt existing tools and interventions to incorporate the model’s principles.

• To measure attitudes toward exercise, readers can refer to Wu et al. (2020). They developed an 18-item scale with good psychometric properties. For questions around other behaviors, such as lifestyle or prevention, readers can refer to Şimşekoğlu and Lajunen (2008).
• To measure HBM constructs around self-examination, see Abraham and Sheeran (2015).
• For readers who are interested in focusing on only one component of the HBM and want to know how to adapt or target those aspects, see Orji et al. (2012). They have a useful table detailing various interventions that can be applied for each submeasure.

Health belief assessment worksheet

The Technical Assistance Network for Children’s Behavioral Health released an extensive toolkit that measures various beliefs around healthcare (Concha et al., 2014).

This 33-item questionnaire was designed to measure questions around health care relating to community, spiritual care, family, knowledge of illness, perceptions of health care practitioners, service delivery, and community.

It is quite extensive and can guide practitioners in uncovering any beliefs or attitudes that might be preventing a client from seeking or persisting in their health care journey. The worksheet is available at the University of Florida website .

SMART goals

To help clients meet their goals, practitioners can guide clients through a goal-setting exercise based on the principles of the health belief model. For example, encourage them to set specific, measurable, achievable, relevant, and time-bound (SMART) goals related to improving their health behaviors.

In this exercise, practitioners can help clients identify strategies to address perceived barriers and enhance the perceived benefits of adopting healthier habits .

Here are two worksheets to help you.

• The first worksheet helps you and your client identify the important questions needed to achieve their goals.
• The second worksheet is a condensed version of the first and can be used to track multiple goals. The second worksheet is useful once your client understands the SMART process.

Decisional balance worksheet

When helping clients make a decision about their health behaviors, practitioners can use a decisional balance worksheet to help clients weigh the pros and cons.

Ask clients to list the advantages and disadvantages of adopting healthier behaviors, considering factors such as perceived benefits, perceived barriers, and the potential outcomes of their actions. This list will help clients gain insight into their own beliefs, make informed decisions, and prioritize goals.

In this decision-making worksheet , clients are asked to list the different options available to them and list the pros and cons associated with each.

If you want to help your client evaluate their past decisions so that they can identify which decisions were good and bad, then the Behavior Self-Evaluation worksheet will help you. Clients are asked to identify previous decisions, evaluate the outcome, and decide whether they would change their decision and why.

By integrating these worksheets and interventions into coaching or counseling sessions, practitioners can effectively apply the principles of the health belief model to support clients in achieving their health and wellness goals. Practitioners will need to adapt existing tools, questions, and worksheets to individual clients to ensure its appropriateness.

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The health belief model is a useful framework for making sense of why we choose whether to participate in certain health behaviors.

With this framework, practitioners can isolate and explore different aspects of clients’ decision-making processes, help clients gain insight into their behavior, and identify the challenges they experience with implementing positive change.

Although the health belief model is not applicable to every situation, it can still be leveraged to gain insight. Remember that change will not be immediate. Help manage your clients’ expectations; small changes are not always visible, but they add up over time.

Before you go, make sure to read these posts about changing behavior in your clients.

• What Is Behavior Change in Psychology? 5 Models and Theories
• How to Change Self-Limiting Beliefs According to Psychology

Let us know in the comments if this post helped you gain insight into your own behavior or that of your clients.

We hope you enjoyed reading this article. Don’t forget to download our three Positive Psychology Exercises for free .

• Abraham, C., & Sheeran, P. (2015). The health belief model. Predicting health behavior: Research and Practice with Social Cognition Models , 2 , 30–55.
• Ahadzadeh, A. S., Sharif, S. P., Ong, F. S., & Khong, K. W. (2015). Integrating health belief model and technology acceptance model: An investigation of health-related internet use. Journal of Medical Internet Research , 17 (2).
• Armitage, C. J., & Conner, M. (2000). Social cognition models and health behaviour: A structured review. Psychology & Health , 15 (2), 173–189.
• Australian Institute of Health and Welfare. (2023, December 1). Cancer screening . Retrieved April 8, 2024, from https://www.aihw.gov.au/reports/australias-health/cancer-screening-and-treatment
• Concha, M., Villar, M. E., & Azevedo, L. (2014). Health attitudes and beliefs tool kit. Technical Assistance Network for Children’s Behavioral Health . University of Maryland, Baltimore.
• Daniati, N., Widjaja, G., Olalla Gracìa, M., Chaudhary, P., Nader Shalaby, M., Chupradit, S., & Fakri Mustafa, Y. (2021). The health belief model’s application in the development of health behaviors. Health Education and Health Promotion , 9 (5), 521–527.
• Gillibrand, R., & Stevenson, J. (2006). The extended health belief model applied to the experience of diabetes in young people. British Journal of Health Psychology , 11 (1), 155–169.
• Janz, N. K., & Becker, M. H. (1984). The health belief model: A decade later. Health Education Quarterly , 11 (1), 1–47.
• Kim, J., & Park, H. A. (2012). Development of a health information technology acceptance model using consumers’ health behavior intention. Journal of Medical Internet Research , 14 (5).
• King, K. A., Vidourek, R. A., English, L., & Merianos, A. L. (2013). Vigorous physical activity among college students: Using the health belief model to assess involvement and social support. Archives of Exercise in Health and Disease , 4 (2), 267–279.
• Limbu, Y. B., Gautam, R. K., & Pham, L. (2022). The health belief model applied to COVID-19 vaccine hesitancy: A systematic review. Vaccines , 10 (6).
• Luquis, R. R., & Kensinger, W. S. (2019). Applying the health belief model to assess prevention services among young adults. International Journal of Health Promotion and Education , 57 (1), 37–47.
• Mercadante, A. R., & Law, A. V. (2021). Will they, or won’t they? Examining patients’ vaccine intention for flu and COVID-19 using the health belief model. Research in Social and Administrative Pharmacy , 17 (9), 1596–1605.
• Orji, R., Vassileva, J., & Mandryk, R. (2012). Towards an effective health interventions design: An extension of the health belief model. Online Journal of Public Health Informatics , 4 (3).
• Renuka, P., & Pushpanjali, K. (2014). Effectiveness of health belief model in motivating for tobacco cessation and to improving knowledge, attitude and behavior of tobacco users. Cancer and Oncology Research , 2 (4), 43–50.
• Sharifirad, G., Entezari, M. H., Kamran, A., & Azadbakht, L. (2009). The effectiveness of nutritional education on the knowledge of diabetic patients using the health belief model. Journal of Research in Medical Sciences , 14 (1).
• Şimşekoğlu, Ö., & Lajunen, T. (2008). Social psychology of seat belt use: A comparison of theory of planned behavior and health belief model. Transportation Research Part F: Traffic Psychology and Behaviour , 11 (3), 181–191.
• Skinner, C. S., Tiro, J., & Champion, V. L. (2015). Background on the health belief model. Health Behavior: Theory, Research, and Practice , 75 , 1–34.
• Tavafian, S. S., Aghamolaei, T., Gregory, D., & Madani, A. (2011). Prediction of seat belt use among Iranian automobile drivers: Application of the theory of planned behavior and the health belief model. Traffic Injury Prevention , 12 (1), 48–53.
• Wong, L. P., Alias, H., Wong, P. F., Lee, H. Y., & AbuBakar, S. (2020). The use of the health belief model to assess predictors of intent to receive the COVID-19 vaccine and willingness to pay. Human Vaccines & Immunotherapeutics , 16 (9), 2204–2214.
• Wu, S., Feng, X., & Sun, X. (2020). Development and evaluation of the health belief model scale for exercise. International Journal of Nursing Sciences , 7 , S23–S30.

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The Health Belief Model

Limitations of health belief model.

All Modules

The Health Belief Model (HBM) was developed in the early 1950s by social scientists at the U.S. Public Health Service in order to understand the failure of people to adopt disease prevention strategies or screening tests for the early detection of disease. Later uses of HBM were for patients' responses to symptoms and compliance with medical treatments. The HBM suggests that a person's belief in a personal threat of an illness or disease together with a person's belief in the effectiveness of the recommended health behavior or action will predict the likelihood the person will adopt the behavior.

The HBM derives from psychological and behavioral theory with the foundation that the two components of health-related behavior are 1) the desire to avoid illness, or conversely get well if already ill; and, 2) the belief that a specific health action will prevent, or cure, illness. Ultimately, an individual's course of action often depends on the person's perceptions of the benefits and barriers related to health behavior. There are six constructs of the HBM. The first four constructs were developed as the original tenets of the HBM. The last two were added as research about the HBM evolved.

• Perceived susceptibility - This refers to a person's subjective perception of the risk of acquiring an illness or disease. There is wide variation in a person's feelings of personal vulnerability to an illness or disease.
• Perceived severity - This refers to a person's feelings on the seriousness of contracting an illness or disease (or leaving the illness or disease untreated). There is wide variation in a person's feelings of severity, and often a person considers the medical consequences (e.g., death, disability) and social consequences (e.g., family life, social relationships) when evaluating the severity.
• Perceived benefits - This refers to a person's perception of the effectiveness of various actions available to reduce the threat of illness or disease (or to cure illness or disease). The course of action a person takes in preventing (or curing) illness or disease relies on consideration and evaluation of both perceived susceptibility and perceived benefit, such that the person would accept the recommended health action if it was perceived as beneficial.
• Perceived barriers - This refers to a person's feelings on the obstacles to performing a recommended health action. There is wide variation in a person's feelings of barriers, or impediments, which lead to a cost/benefit analysis. The person weighs the effectiveness of the actions against the perceptions that it may be expensive, dangerous (e.g., side effects), unpleasant (e.g., painful), time-consuming, or inconvenient.
• Cue to action - This is the stimulus needed to trigger the decision-making process to accept a recommended health action. These cues can be internal (e.g., chest pains, wheezing, etc.) or external (e.g., advice from others, illness of family member, newspaper article, etc.).
• Self-efficacy - This refers to the level of a person's confidence in his or her ability to successfully perform a behavior. This construct was added to the model most recently in mid-1980. Self-efficacy is a construct in many behavioral theories as it directly relates to whether a person performs the desired behavior.

There are several limitations of the HBM which limit its utility in public health. Limitations of the model include the following:

• It does not account for a person's attitudes, beliefs, or other individual determinants that dictate a person's acceptance of a health behavior.
• It does not take into account behaviors that are habitual and thus may inform the decision-making process to accept a recommended action (e.g., smoking).
• It does not take into account behaviors that are performed for non-health related reasons such as social acceptability.
• It does not account for environmental or economic factors that may prohibit or promote the recommended action.
• It assumes that everyone has access to equal amounts of information on the illness or disease.
• It assumes that cues to action are widely prevalent in encouraging people to act and that "health" actions are the main goal in the decision-making process.

The HBM is more descriptive than explanatory, and does not suggest a strategy for changing health-related actions. In preventive health behaviors, early studies showed that perceived susceptibility, benefits, and barriers were consistently associated with the desired health behavior; perceived severity was less often associated with the desired health behavior. The individual constructs are useful, depending on the health outcome of interest, but for the most effective use of the model it should be integrated with other models that account for the environmental context and suggest strategies for change.

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How the Health Belief Model Influences Your Behaviors

Elizabeth Boskey, PhD, MPH, CHES, is a social worker, adjunct lecturer, and expert writer in the field of sexually transmitted diseases.

Carly Snyder, MD is a reproductive and perinatal psychiatrist who combines traditional psychiatry with integrative medicine-based treatments.

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• Effectiveness

Frequently Asked Questions

The Health Belief Model (HBM) is a tool that scientists use to try to predict health behaviors. It was originally developed in the 1950s and proposed by social psychologists Godfrey Hochbaum, Irwin Rosenstock, and Rosenstock and Kirscht. The model is based on the theory that a person's willingness to change their health behaviors primarily comes from their health perceptions.

According to this model, your individual beliefs about health and health conditions play a role in determining your health-related behaviors. Key factors that affect your approach to health include:

• Any barriers you think might be standing in your way
• Exposure to information that prompts you to take action
• How much of a benefit you think you'll get from engaging in healthy behaviors
• How susceptible you think you are to illness
• What you think the consequences will be of becoming sick
• Your confidence in your ability to succeed

Health experts often look for ways that Health Belief Models can affect the actions people take, including behaviors that can have an impact on both individual and public health.

This article discusses how the Health Belief Model works, the different components of the model, and how this approach can be used to address health-related behaviors.

What Are the Components of the Health Belief Model?

There are six main components of the Health Belief Model. Four of these constructs were main tenets of the theory when it was first developed. Two were added in response to research on the model related to addiction.

Perceived Severity

The probability that a person will change their health behaviors to avoid a consequence depends on how serious they believe the consequences will be. For example:

• If you are young and in love, you are unlikely to avoid kissing your sweetheart on the mouth just because they have the sniffles and you might get their cold. On the other hand, you probably would stop kissing if it might give you a more serious illness.
• Similarly, people are less likely to consider condoms when they think STDs are a minor inconvenience. That's why receptiveness to messages about safe sex increased during the AIDS epidemic. The perceived severity increased enormously. 

The severity of an illness can have a major impact on health outcomes. However, a number of studies have shown that perceived risk of severity is actually the least powerful predictor of whether or not people will engage in preventive health behaviors.

Perceived Susceptibility

People will not change their health behaviors unless they believe that they are at risk. For example:

• Individuals who do not think they will get the flu are less likely to get a yearly flu shot.
• People who think they are unlikely to get skin cancer are less likely to wear sunscreen or limit sun exposure.
• Those who do not think that they are at risk of acquiring HIV from unprotected intercourse are less likely to use a condom.
• Young people who don't think they're at risk of lung cancer are less likely to stop smoking.

Research suggests that perceived susceptibility to illness is an important predictor of preventive health behaviors.  

Perceived Benefits

It's difficult to convince people to change a behavior if there isn't something in it for them. People don't want to give up something they enjoy if they don't also get something in return. For example:

• A person probably won't stop smoking if they don't think that doing so will improve their life in some way.
• A couple might not choose to practice safe sex if they don't see how it could make their sex life better. 
• People might not get vaccinated if they do not think there is an individual benefit for them.

These perceived benefits are often linked to other factors, including the perceived effectiveness of a behavior. If you believe that getting regular exercise and eating a healthy diet can prevent heart disease, that belief increases the perceived benefits of those behaviors.

Perceived Barriers

One of the major reasons people don't change their health behaviors is that they think doing so is going to be hard. Changing health behaviors can require effort, money, and time. Commonly perceived barriers include:

• Amount of effort needed
• Inconvenience
• Social consequences

Sometimes it's not just a matter of physical difficulty, but social difficulty as well. For example, If everyone from your office goes out drinking on Fridays, it may be very difficult to cut down on your alcohol intake. If you think that condoms are a sign of distrust in a relationship, you may be hesitant to bring them up. 

Perceived barriers to healthy behaviors have been shown to be the single most powerful predictor of whether people are willing to engage in healthy behaviors.  

When promoting health-related behaviors such as vaccinations or STD prevention, finding ways to help people overcome perceived barriers is important. Disease prevention programs can often do this by increasing accessibility, reducing costs, or promoting self-efficacy beliefs.

Cues to Action

One of the best things about the Health Belief Model is how realistically it frames people's behaviors. It recognizes the fact that sometimes wanting to change a health behavior isn't enough to actually make someone do it.

Because of this, it includes two more elements that are necessary to get an individual to make the leap. These two elements are cues to action and self-efficacy.

Cues to action are external events that prompt a desire to make a health change. They can be anything from a blood pressure van being present at a health fair, to seeing a condom poster on a train, to having a relative die of cancer. A cue to action is something that helps move someone from wanting to make a health change to actually making the change.

Self-Efficacy

Self-efficacy wasn't added to the model until 1988. Self-efficacy looks at a person's belief in their ability to make a health-related change. It may seem trivial, but faith in your ability to do something has an enormous impact on your actual ability to do it.

Finding ways to improve individual self-efficacy can have a positive impact on health-related behaviors. For example, one study found that women who had a greater sense of self-efficacy toward breastfeeding were more likely to nurse their infants longer. The researchers concluded that teaching mothers to be more confident about breastfeeding would improve infant nutrition.

Thinking that you will fail will almost make certain that you do. Self-efficacy has been found to be one of the most important factors in an individual's ability to successfully negotiate condom use.

There are six components of the Health Belief Model. They are perceived severity, perceived susceptibility, perceived benefits, perceived barriers, cues to action, and self-efficacy.

Examples and Uses of the Health Belief Model

It can be helpful to look at how the Health Belief Model can be applied in different situations. One important aspect of public health is the design of programs that encourage people to engage in healthy behaviors, so understanding how this model can be applied to different situations can be useful.

For example, experts may be interested in understanding public attitudes about cancer screenings. Looking at factors like perceptions of the risk of getting cancer, the benefits of being screened for cancer, and the barriers to being screened can help healthcare professionals look for ways to encourage people to get screened.

The model may also be used for public health programs that are used in different settings. Schools, for example, may rely on educational programs to help children understand challenges regarding health, substance use, physical activity, nutrition, and personal safety. Such programs are often based on the Health Belief Model and work to educate, offer skills training, reduce barriers, and boost self-efficacy.

Healthcare professionals and public health experts can apply the Health Belief Model to create programs and interventions designed to help prevent health problems, encourage treatment behaviors , and support behavior change.

How Effective Is the Health Belief Model?

The Health Belief Model has been used for decades to help produce behavior change interventions. Research suggests that the Health Belief Model can be helpful for designing strategies to help promote healthy behaviors and to improve the prevention and treatment of health conditions. 

In a study published in the journal Health Psychology Review , researchers found that in studies looking at the Health Belief Model, 78% reported significant improvement in behavior adherence. Of the studies they looked at, 39% reported moderate to large effects related to health interventions.

Criticisms of the Health Belief Model

The Health Belief Model is not without criticism. Some of the limitations of this approach to understanding health include:

• It does not take into account how people's decisions may be shaped by habitual behaviors. 
• It focuses on health-related reasons for behaviors but ignores the fact that people often engage in actions for other reasons, such as social acceptance.
• It doesn't address the economic and environmental factors that can affect a person's health behavior. Living in a food desert or lacking the economic resources to afford fresh fruits and vegetables, for example, can be a major barrier to making healthy food choices.
• The model doesn't address the individual beliefs, attitudes, and other characteristics that affect how readily a person can change their behavior.

Critics also suggest that the model focuses on describing health behaviors rather than explaining how to change them. 

Some limitations of the Health Belief Model include it does not adequately address some of the individual factors that affect health behaviors. It also fails to account for how environmental factors, including social variables, impact a person's health choices.

A Word From Verywell

The Health Belief Model can be a helpful way for health educators to design interventions that can improve both individual and public health. By understanding the factors that influence the health choices people make, programs can tackle ways to reduce barriers, improve knowledge, and help people feel more motivated to take action .

It can also be a useful tool for thinking about your own approach to your health. Consider how things such as perceived susceptibility, perceived barriers, self-efficacy, and other elements of the model influence your choices, then look for things that you can do to make healthier choices in your life.

The Health Belief Model was created by social psychologists Irwin M. Rosenstock, Godfrey M. Hochbaum, S. Stephen Kegeles, and Howard Leventhal during the 1950s. It was developed for the U.S. Public Health Services to understand why people fail to engage in healthy behaviors.

One of the main benefits of the Health Belief Model is that it simplifies health-related constructs so they can be more readily tested and implemented in public health settings. Because it emphasizes some of the prerequisites for health behaviors, it can be helpful for addressing the things that need to happen before a person can successfully implement a behavior change.

The Health Promotion Model is a multidimensional approach that takes into account how a person's interaction with their environment affects their health choices. It is similar to the Health Belief Model in some ways, but where the HBM is focused on being health-protective, the Health Promotion Model focuses more on helping people improve their well-being and achieve self-actualization .

Ghorbani-Dehbalaei M, Loripoor M, Nasirzadeh M. The role of health beliefs and health literacy in women’s health promoting behaviours based on the health belief model: a descriptive study .  BMC Women’s Health . 2021;21(1):421.

Jones CL, Jensen JD, Scherr CL, Brown NR, Christy K, Weaver J. The Health Belief Model as an explanatory framework in communication research: Exploring parallel, serial, and moderated mediation .  Health Commun . 2015;30(6):566-576. doi:10.1080/10410236.2013.873363

Loke AY, Chan LK. Maternal breastfeeding self-efficacy and the breastfeeding behaviors of newborns in the practice of exclusive breastfeeding .  J Obstet Gynecol Neonatal Nurs . 2013;42(6):672-684. doi:10.1111/1552-6909.12250

Montanaro EA, Bryan AD. Comparing theory-based condom interventions: Health belief model versus theory of planned behavior . Health Psychol . 2014;33(10):1251-60. doi:10.1037/a0033969

Baghianimoghadam MH, Shogafard G, Sanati HR, Baghianimoghadam B, Mazloomy SS, Askarshahi M. Application of the Health Belief Model in promotion of self-care in heart failure patients . Acta Med Iran . 2013;51(1):52-8.

Jones CJ, Smith H, Llewellyn C. Evaluating the effectiveness of health belief model interventions in improving adherence: a systematic review . Health Psychol Rev . 2014;8(3):253-69. doi:10.1080/17437199.2013.802623

Orji R, Vassileva J, Mandryk R. Towards an effective health interventions design: an extension of the health belief model .  Online J Public Health Inform . 2012;4(3):ojphi.v4i3.4321. doi:10.5210/ojphi.v4i3.4321

Carpenter CJ. A meta-analysis of the effectiveness of health belief model variables in predicting behavior . Health Commun . 2010;25(8):661-9. doi:10.1080/10410236.2010.521906

Galloway RD. Health promotion: causes, beliefs and measurements .  Clin Med Res . 2003;1(3):249-258. doi:10.3121/cmr.1.3.249

By Elizabeth Boskey, PhD Elizabeth Boskey, PhD, MPH, CHES, is a social worker, adjunct lecturer, and expert writer in the field of sexually transmitted diseases. 

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There are hundreds of theories relevant for precision research on home visiting services and implementation systems. HARC’s objective is to develop resources focused on theories to build capacity of researchers who wish to use them. This resource provides a brief summary of the Health Belief Model including general descriptions of the theory, a diagram of the theory’s key constructs, application of the theory to the Precision Paradigm, and intervention researcher ratings of the theory quality and relevance to home visiting.

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