Health Belief Model: Need for More Utilization in Alcohol and Drug Education

The health belief model (HBM) is one of the first theories developed exclusively for health-related behaviors (Sharma & Romas, 2012). Although labeled a "model," the HBM meets all the criteria for a behavioral theory. The HBM originated in the 1950s and has been thoroughly tested in a variety of situations since that time. Today it is one of the most popular models, as it provides specific guidance at the micro level for planning the "how to" part of interventions. Based on experimentation over the years, the HBM has expanded and borrowed from other theories to strengthen its predictive and explanatory potential. The HBM has six constructs, the first of which is perceived susceptibility. This refers to the subjective belief that a person has with respect to acquiring a disease or reaching a harmful state as a result of indulging in a particular behavior. Individuals vary considerably in their perception of susceptibility to any given illness or harmful condition. On one extreme are individuals who completely deny any possibility of their acquiring the disease. In the middle are people who may admit to the possibility of acquiring the disease but believe it is not likely to happen to them. At the other extreme are people who are so fearful of acquiring the disease that they believe they will in all probability acquire it. The more susceptible a person feels, the greater the likelihood of his or her taking preventive measures. The second construct of HBM is perceived severity, which refers to a person's subjective belief in the extent of harm that can result from the disease or harmful state resulting in a particular behavior. This perception also varies from person to person. One person might perceive the disease from a purely medical perspective and thus be concerned with signs, symptoms, any limitations arising out of the condition, the temporary or permanent nature of the condition, its potential for causing death, and so on. Another individual might look at the disease from a broader perspective, such as the adverse effects it might have on his or her family, job, and relationships. The constructs of perceived severity and perceived susceptibility are often grouped together and called perceived threat. The third construct of the HBM is perceived benefits, which refers to belief in the advantages of the methods suggested for reducing the risk or seriousness of the disease or harmful state resulting from a particular behavior. The relative effectiveness of known available alternatives plays a role in shaping actions. An alternative is likely to be seen as beneficial if it reduces the perceived susceptibility or perceived severity of the disease. The fourth construct, which goes hand in hand with the construct of perceived benefits, is perceived barriers. Perceived barriers refer to beliefs concerning the actual and imagined costs of following the new behavior. An individual may believe that a new action is effective in reducing perceived susceptibility or perceived severity of the disease but may consider the action to be expensive, inconvenient, unpleasant, painful, or upsetting. The fifth construct in the HBM is cues to action, which are the precipitating forces that make a person feel the need to take action. These cues may be internal (e.g., perception of a bodily state) or external (e.g., interpersonal interactions, media communication, or receiving a postcard from the doctor for a follow-up examination). The final construct is self-efficacy which was added to the model in the 1980s (Rosenstock, Strecher, & Becker 1988). Self-efficacy is the confidence that a person has in his or her ability to pursue a behavior. It is behavior specific and is in the present. It is not about the past or future. Health belief model has been utilized in alcohol and drug education to some extent. Von and colleagues (2004) used this model to predict alcohol, smoking, and other behaviors in college students. …