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Theories & Approaches

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How Can I Use the Health Belief Model in My Setting?

The Health Belief Model (HBM) can be used alone as the theoretical basis of a health education program, or it can be used in combination with other models, learning theories and approaches. Since no model or learning theory can explain or predict all aspects of health behavior, combining compatible theories and models can create stronger health education programs. The HBM is often combined with Social Learning Theories in health education programs.

You can use the HBM in your work with youth by:

  • using it as a theoretical framework to better understand the current curricula you are using;

  • using it as the theoretical framework for developing new programs and curricula; or

  • adapting your current curriculum or program by adding key elements of the HBM.

If you are interested in incorporating the HBM into the curriculum you currently use, the following checklist and corresponding implementation ideas have been designed to help you.

Key
Condition = pregnancy, STIs, HIV
Recommended Health Actions = abstaining from sex or using condoms

Checklist for Educators Implementation Ideas
(applicable HBM concepts appear in parentheses)
1. Do you include an activity that increases students' perception of their own vulnerability to the condition?
  • Show students videos which have youth like them with the condition.

  • Ask youth to complete confidential personal risk assessments.

  • Present recent statistics of youth their age, or from their community, with the condition.

  • Have them explore web sites that show teens with the condition.

  • Invite guest speakers who look like the youth to share their experiences with the condition.

(Perceived Susceptibility)

2. Do you assess students' perception of their own vulnerability to the condition?
  • Generate discussion about whether or not students feel they could get the condition.

  • Ask students to anonymously write down on an index card whether they believe they could get the condition and then collect the cards.

  • Have students analyze the results of their personal risk assessments (under #1 above) and generate a discussion of their perceptions.

(Perceived Susceptibility)

3. Do you include activities that teach the seriousness of the condition and its consequences?
  • Show graphic photos of people suffering with STIs and HIV.

  • Share case studies of people experiencing difficult consequences of the condition.

  • Lead a visualization having youth imagine they have the condition and are dealing with its consequences.

  • Tell youth to imagine having the condition and ask them to each write a letter to their best friend explaining what happened and how it feels to have the condition.

  • Share compelling statistics of negative consequences of the condition.

  • Invite a guest speaker with the condition to explain what he/she has had to cope with under the circumstances.

  • Show a video showing people with the condition talking about how their lives have changed.

  • Ask students to brainstorm at least 20 ways the condition would change their lives.

(Perceived Severity)

4. Do you assess students' perception of the severity of the condition?
  • Ask youth to answer questions about how serious the condition is, or how much they want to avoid it (e.g., on a scale of 1 - 5).

  • Ask students to write down on index cards whether or not they believe the condition is serious, with their reasons, and collect the cards.

(Perceived Severity)

5. Do you clearly present the desired action to take to avoid the condition?
  • Present the desired action in various ways — explain it, post it, distribute it in print, and reinforce it throughout the session.

  • Model how to take the action in front of the group.

  • Be sure students have all the information they need to take the action (e.g., where to get condoms, how to choose, how to store, when to use them, how to put them on and remove them, etc.)

  • Clearly present the benefits of the recommended action using reliable resources (e.g. information or statistics from the Centers for Disease Control and Prevention [CDC], Surgeon General, etc.).

(Perceived Benefits)

6. Do you assess whether the youth believe the action will benefit them by preventing the condition?
  • Generate discussion among students about whether they really think that the action will prevent the condition (including their reasoning).

  • Have youth in triads discuss whether they believe that the desired action will prevent the condition. Have each triad report back to the class, listing the different reasons reported on the board.

  • Invite youth to voice any doubts they may have about the benefits of the desired action and then gently help them see all sides of the issue.

  • Have a guest youth who experiences benefits from using the action address the class. Alternatively, a video may be used.

(Perceived Benefits)

7. Do you help youth identify their personal barriers to action?
  • Have the group brainstorm all imagined barriers to taking action. Then ask each youth to pick out one or two barriers that apply to them.

  • Give each youth a list of common barriers to taking action. Ask them to circle the ones that apply to them.

  • Show a video or present a case study in which youth can recognize barriers experienced by someone else. Ask them if they can relate.

(Perceived Barriers)

8. Do you support youth in reducing or eliminating barriers (or perception of barriers) to taking action?
  • Consider whether perceived barriers can be reduced by helping youth obtain additional information, use more time for skill-building, or build their own confidence taking action.

  • Ask youth to role-play advising a younger sibling or friend who is faced with the same barriers to taking action.

  • Brainstorm with large group strategies to overcome each barrier.

  • If subject matter is not too sensitive, have youth work in small groups to brainstorm ways to reduce stated barriers.

(Perceived Barriers)

9. Do you provide youth with cues to action?
  • Provide youth with incentive items (e.g., pencils, key chains) which contain visual reminders of the message or recommended action.

  • Hang posters with the action messages in your setting.

  • Encourage youth to write newsletter articles or take on art projects to creatively express the action message.

  • Organize school or agency-wide events showcasing the action message.

  • Encourage students to discuss the recommended action with their parents or other responsible adults.

(Cues to Action)

10. Do you assess whether your students feel confident that they can take the recommended action correctly?

Educators should determine their students’ level of confidence in using a skill or taking an action by:

  • Observing their skill practice;

  • Promoting discussion with them about their practice experience, which may bring up doubts or perceived barriers to confidently using the skill;

  • Positively reinforcing desired behaviors and steps to the desired behaviors.

  • Conducting a brief anonymous survey after the skill building session to elicit questions or concerns that remain.

(Self-efficacy)

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Next: Challenges and Considerations in Applying the Health Belief Model