The health belief model
- Theory
It says a person acts for their health when they feel at risk, see the problem as serious, believe the action works and face few obstacles.
What it is
The health belief model was created in the 1950s by social psychologists at the US Public Health Service to understand why so few people used free chest X-ray screening for tuberculosis. It proposes that behaviour depends on how a person perceives a threat and how they weigh the recommended action. It now has six components and is used to design screening, vaccination and adherence campaigns.
Key facts
- Perceived threat = susceptibility + severity; outcome expectation = benefits minus barriers.
- Modifying factors: age, sex, education, culture and prior knowledge shape all the beliefs.
- It rests on a core cognitive-behavioural idea: knowledge is necessary but not enough for change.
- It fits best for behaviour driven by health concern, such as screening or sexual risk behaviour.
The model's components applied to a person with hypertension and no symptoms
| Component | Belief that favours action | Clinician strategy |
|---|---|---|
| Susceptibility | ‘Even though I feel nothing, my blood pressure is high’ | Show their own readings and explain their personal risk |
| Severity | ‘It could cause a heart attack or a stroke’ | Explain the consequences without alarmism |
| Benefits | ‘Treatment lowers that risk’ | Give clear figures on the expected benefit |
| Barriers | ‘It is not that expensive or that hard’ | Sort out cost, side effects and complexity; correct myths |
| Cues to action | ‘The phone alarm reminds me’ | Reminders, calls, dose calendar |
| Self-efficacy | ‘I can do this every day’ | Small goals, practice and praise for progress |
Clinical notes
- Limits: it handles habits, emotions and social pressure poorly; susceptibility and severity predict less than barriers.
- It explains poor adherence in symptom-free disease: if the person does not feel ill, perceived threat is low.
Test yourself
Think of the answer, then tap the question to see it.
Why was the health belief model created?
To explain why so few people used the free tuberculosis screening offered by the US Public Health Service in the 1950s.
A woman skips her Pap test because nobody can look after her children. Which component explains this?
Perceived barriers: for her, the practical cost of acting outweighs the expected benefit.
Which component was added later to the original model?
Self-efficacy, the person's confidence that they can carry out the recommended behaviour.
What is a cue to action, and what is an example?
An internal or external trigger for the behaviour, such as a symptom, a doctor's reminder or a vaccination campaign.
Connections
Educational content on behavior and the clinical relationship; not a diagnostic or treatment guide and no substitute for assessment by a health professional. If you or someone near you is at risk, seek help now from an emergency service or a mental-health helpline.
Sources: Theory at a Glance: A Guide For Health Promotion Practice (Second Edition) (National Cancer Institute, National Institutes of Health (US), 2005); Perceived Severity (National Cancer Institute, Division of Cancer Control and Population Sciences (US), 2020).
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Representative model, for educational purposes only.