The Health Belief Model


According to Carpenter (2010), the beginnings of the health belief model (HBM) can be traced to the 1950s when concerns among U.S. public health service providers bordered towards the lack of concern among members of the public about their physical and psychological health in regards to involvement in preventive and disease detection programs. To address the problem, a conglomerate of U.S. social psychologists developed the HBM from a combination of several behavioral theories among them the Kurt Lewin and colleague’s theory, Rotter’s Reinforcement Model, Edward’s Subjective Expected Utility Model, and Tolman’s Performance Behaviour Theory among many more (Carpenter, 2010).

In total there are six constructs of the HBM as follows; (a) Perceived susceptibility: regards individuals the belief that harm will occur due to behavior. (b) Perceived severity: the belief that certain extent of harm can result from a disease developed by behavior. (c) Perceived benefits: belief in the advantages of interventions suggested towards reducing the harm of particular behavior. (d) Perceived barriers: The belief in actual or imagined costs of the intervention behavior.  (e) Cues to action: The willingness or need for an individual to take action in implementing intervention behavior. (f) Self-efficacy: The confidence an individual has in the abilities to pursue intervention behavior (Carpenter, 2010). The premise of this paper is to review the application of HBM in two research papers as advanced by Rossen et al. (2015) and Koch (2002).

Rossen et al. (2015).

The first article by Rossen et al. (2015) from the onset made a lucid attempt at incorporating the HBM as a theoretical construct for the research paper. Foremost, the research paper did not focus primarily on the HBM as the theoretical construct around which the paper was built. Instead, the paper focussed on two other constructs that include the Social Cognitive Theory and the Stages of Change Model. Hence, the HBM was one among the three theoretical models that informed the compilation of the study components. Notwithstanding, the authors do not make an attempt at extrapolating on either of the models through a thorough discussion of components or features of each theory. In fact, there is no attempt by the authors at all to explain what any of the behavioral theories incorporated in the paper advance beyond mentioning that the intervention model (The Sophia Step Study) utilized for the research drew its foundations from the three theoretical models. Hence, no attempt was made to explain any of the six components of the HBM as detailed in the introduction section of this analysis. Further evaluation of the research topic as presented by Rossen et al. (2015) reveals that the authors were on whether or not physical activity promotion in the primary care setting in pre and type 2 diabetes was achievable through administering the Sophia step study? To that extent, the evaluation proves that the research question was appropriate for the application of the HBM. As such, the HBM is a behaviorist theory whereas the research sought to understand behavior where physical activity as an intervention was measured by its success or failure as an intervention for treating patients with diabetes.

Moving forward, an evaluation of the validity reliability of the use of the HBM by the authors as a guide that shaped the description, design, analysis, and results of the study reveals a lacking of application. Consequently, the authors do not offer explanations of a direct correlation between the theory and the outcomes of the experiment.  However, little attempt is done to link the analysis of the data collected from the respondents to theoretical models used in the study. Nonetheless, the authors do not make any differentiations between which models among the three are responsible for exerting a certain influence in either of the interventions used that mainly included pedometer and webpage, individual counseling, and group meetings. From a broader perspective other than mentioning that the HBM is a model of understanding behavioral attributes, the authors make little to no attempt at advancing knowledge about the content of the theory and how it connects with the context of the experiment at hand. Hence, the recommendation necessary for the improvement of the journal would be that it focusses on a single behavioral theory instead of three and that more should be done to show relationships between theory and research outcomes.

Koch (2002).

Koch’s study unlike Rossen et al.’s (2015), makes a noteworthy attempt at explaining the theory of HBM by dedicating a section of the paper to the evaluation of the HBM in accordance with the study at hand. In that esteem, Koch (2002) explains that the HBM is a theory useful in evaluating health behavior, particularly when examining compliance with physician directives among patients. In that esteem, the HBM is presented as to contain components of compliance. Specifically, Koch (2002) points out two components of the HBM that include perceived barriers and perceived benefits as pertaining to compliance with regimen associated with diabetes conditions among elderly African-American women. However, no complete explanation of the HBM’s components is presented other than the ones that have everything to do with the research, and as such, prove to be of relevance to the research topic. To that extent, it is fair to deduce that unlike Rossen et al.’s (2015) lack of attempt to explain the components of the HBM, Koch (2002) makes a partial attempt at explaining two components of the HBM as relevant to the investigation of the research question under evaluation.

Consequently, it is without much doubt that the relevance of the use of the HBM as a precursor for the development of a theoretical foundation of the research report is justified. In other words, the research’s focus, question, and problem statement all tie well together with the theoretical HBM as a theoretical model on which the study was founded. As such, the research sought to evaluate compliance with exercising regimen as a behavioral catalyst towards the management of diabetes in elderly African-American women. To that extent, the research question, focus, and problem statement are well informed by the theoretical underpinnings of the HBM. Further, an evaluation of the connections that Koch (2002) develops between the study design, results, analysis, and data interpretations attributes reveals in-depth incorporation of theoretical models in the entire paper. For instance, the HBM is specifically used as a research tool on which the measuring scale of behavioral evaluation is founded. For that reason, all measurements of differences in compliance with diabetes management regimen were devised around the HBM theory to evaluate the level of commitment of the participants towards managing their diabetes conditions. Moreover, the discussion section draws from inferences of the HBM theory which explains concepts such as perceived barriers and perceived self-efficacy among others as attributes of components of the HBM which directly contribute to compliance with regimen outcomes. The results of the research also reflect a direct allusion to the theory of HBM where barriers and benefits of diabetes management are explicitly mentioned as aspects of influence in regimen compliance both of which are components of the HBM theory. In a nutshell, the paper by Koch (2002) comprehensively incorporates the HBM as a theoretical foundation for the research report. More so, the incorporation of the HBM is adequately applied throughout the content and context of the research paper from the introduction to a conclusion as discussed.


Essentially, the HBM constitutes theoretical thinking that pertains to behavioral developments as subject to six enforcers of perception as presented in the introduction section of this report. The evaluation of two research articles applying the HBM model reveals that one was well incorporated while the other did not do well to convince the reader that the HBM was effectively applied in the completion of the research report. To that extent, Koch’s (2002) article proves to be the one that thoroughly and adequately applied the concept of HBM in its analysis and investigation of the research topic. This evaluation also finds that although Rossen et al.’s (2015) article did not adequately address issues pertaining to the application and explanation of the HBM theory, both Rossen et al. (2015) and Koch (2002) sought to investigate phenomenon that had relevance or proved valid for the application of the HBM as a basis for theoretical thinking. What is more, both literature authors make attempts at making a connection between behavioral evaluation and the theory of HBM. In a nutshell, Koch (2002) proves to be more systematic, valid, and reliable as a study applying HBM in its investigation when compared to Rossen et al. (2015) as discussed.


Carpenter, C. J. (2010). A meta-analysis of the effectiveness of health belief model variables in predicting behavior. Health Communication, 25(8), 661-669. doi:10.1080%2F10410236.2010.521906

Koch, J. (2002). The Role of Exercise in the AfricanAmerican Woman with Type 2 Diabetes Mellitus: Application of the Health Belief Model. Journal of the American Academy of Nurse Practitioners14(3), 126-130. ‏

Rossen, J., Yngve, A., Hagströmer, M., Brismar, K., Ainsworth, B. E., Iskull, C., … & Johansson, U. B. (2015). Physical activity promotion in the primary care setting in pre-and type 2 diabetes-the Sophia step study, an RCT. BioMed Centeral Public Health15(1), 1-11. ‏‏