The Health Belief Model and Predictions of Health Actions

  • John P. Kirscht


An important role of applied social science in health has been the promulgation of theory designed to account for health behaviors of individuals and groups. Efforts to model various health-related actions have multiplied and become increasingly sophisticated. Stone (1979), in his comprehensive review of psychology and the health system, noted that “the questions of why people behave as they do and how they may be induced to behave differently have represented the core of American psychology throughout this century” (p. 70). Recent growth in the study of health behavior has significant roots in the pioneering efforts of applied psychologists and sociologists, represented in the frameworks outlined in the seminal article by Kasl and Cobb (1966). As noted by Leventhal, Zimmerman, and Gutmann (1984) in their critical review, “the health belief model is the cognitive model most frequently used in studies of health behavior and compliance” (p. 384).


Health Behavior Behavioral Medicine Health Belief Health Belief Model Applied Social Psychology 
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  1. Bandura, A. (1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84, 191–215.PubMedCrossRefGoogle Scholar
  2. Bauman, K., & Chenoweth, R. (1984). The relationship between the consequences adolescents expect from smoking and their behavior: A factor analysis with panel data. Journal of Applied Social Psychology, 14, 28–41.CrossRefGoogle Scholar
  3. Beck, K., & Frankel, A. (1981). A conceptualization of threat communications and protective health behavior. Social Psychology Quarterly, 44, 204–217.PubMedCrossRefGoogle Scholar
  4. Beck, K., & Lund, A. (1981). The effects of health threat seriousness and personal efficacy upon intentions and behavior. Journal of Applied Social Psychology, 11, 401–415.CrossRefGoogle Scholar
  5. Becker, M. (Ed.). (1974). The health belief model and personal health behavior. Thorofare, NJ: Charles B. Slack.Google Scholar
  6. Becker, M., Drachman, R., & Kirscht, J. (1972). Predicting mothers’ compliance with pediatric medical regimens. Journal of Pediatrics, 81, 843–854.PubMedCrossRefGoogle Scholar
  7. Becker, M., Haefner, D., Kasl, S., Kirscht, J., Maiman, L., & Rosenstock, I. (1977). Selected psychosocial models and correlates of individual health-related behaviors. Medical Care, 15 (Suppl.), 27–48.PubMedCrossRefGoogle Scholar
  8. Becker, M., Maiman, L., Kirscht, J., Haefner, D., & Drachman, R. (1977). The health belief model and dietary compliance: A field experiment. Journal of Health and Social Behavior, 18, 348–366.PubMedCrossRefGoogle Scholar
  9. Berkanovic, E., Telesky, C. & Reeder, S. (1981). Structural and social psychological factors in the decision to seek medical care for symptoms. Medical Care, 19, 693–709.PubMedCrossRefGoogle Scholar
  10. Bodenheimer, H., Fulton, J., & Kramer, P. (1986). Acceptance of hepatitis B vaccine among hospital workers. American Journal of Public Health, 76, 252–255.PubMedCrossRefGoogle Scholar
  11. Brock, B. (1984). Factors influencing intentions and behavior toward swine flu vaccine. Doctoral dissertation, University of Michigan.Google Scholar
  12. Calnan, M., & Moss, S. (1984). The health belief model and compliance with education given at a class in breast self-examination. Journal of Health and Social Behavior, 25, 198–210.PubMedCrossRefGoogle Scholar
  13. Carter, W., Beach, L., Inui, T., Kirscht, J., & Prodzinski, J. (1986). Developing and testing a decision model for predicting influenza vaccination compliance. Health Services Research, 20 (6, Pt. II), 897–932.PubMedGoogle Scholar
  14. Cummings, K., Becker, M., Kirscht, J., & Levin, N. (1982). Psychosocial factors affecting adherence to medical regimens in a group of hemodialysis patients. Medical Care, 20, 567–580.PubMedCrossRefGoogle Scholar
  15. Cummings, K., Becker, M., & Maile, M. (1980). Bringing the models together: An empirical approach to combining variables used to explain health actions. Journal of Behavioral Medicine, 3, 123–145.PubMedCrossRefGoogle Scholar
  16. Cummings, K., Jette, A., Brock, B., & Haefner, D. (1979). Psychosocial determinants of immunization behavior in a swine influenza campaign. Medical Care, 17, 639–649.PubMedCrossRefGoogle Scholar
  17. Dielman, T., Leech, S., Becker, M., Rosenstock, I., & Horvath, W. (1982). Parental and child health beliefs and behaviors. Health Education Quarterly, 9, 156–173.PubMedCrossRefGoogle Scholar
  18. Eisen, M., & Zellman, G. (1986). The role of health belief attitudes, sex education, and demographics in predicting adolescents’ sexuality knowledge. Health Education Quarterly, 13, 9–22.PubMedCrossRefGoogle Scholar
  19. Fishbein, M., & Ajzen, I. (1975). Belief, attitude, intention, and behavior: An introduction to theory and research. Reading, MA: Addison-Wesley.Google Scholar
  20. Flay, B. (1985). Psychosocial approaches to smoking prevention: A review of findings. Health Psychology, 4, 449–488.PubMedCrossRefGoogle Scholar
  21. Gochman, D. (1972). Development of health beliefs. Psychological Reports, 31, 259–266.PubMedCrossRefGoogle Scholar
  22. Grady, K., Kegeles, S., Lund, A., Wolk, C., & Farber, N. (1983). Who volunteers for a breast self-examination program? Evaluating the bases for self-selection. Health Education Quarterly, 10, 79–94.PubMedCrossRefGoogle Scholar
  23. Haefner, D. (1974). The health belief model and preventive dental behavior. Health Education Monographs, 2, 420–432.CrossRefGoogle Scholar
  24. Haefner, D., & Kirscht, J. (1970). Motivational and behavioral effects of modifying health beliefs. Public Health Reports, 85, 478–484.PubMedCrossRefGoogle Scholar
  25. Hallal, J. (1982). The relationship of health beliefs, health locus of control, and self-concept to the practice of breast-self-examination in adult women. Nursing Research, 31, 137–142.PubMedCrossRefGoogle Scholar
  26. Harris, D., & Guten, S. (1979). Health protective behavior: An exploratory study. Journal of Health and Social Behavior, 20, 17–29.PubMedCrossRefGoogle Scholar
  27. Hershey, J., Morton, B., Davis, J., & Reichgott, M. (1980). Patient compliance with antihypertensive medication. American Journal of Public Health, 70, 1081–1089.PubMedCrossRefGoogle Scholar
  28. Hochbaum, G. (1958). Participation in medical screening programs: A sociopsychological study. U.S. Public Health Service Publication No. 572.Google Scholar
  29. Howe, H. (1981). Social factors associated with breast self-examination among high risk women. American Journal of Public Health, 71, 251–255.PubMedCrossRefGoogle Scholar
  30. Hunt, W., Matarazzo, J., Weiss, S., & Gentry, W. (1979). Associative learning, habit, and health behavior. Journal of Behavioral Medicine, 2, 111–124.PubMedCrossRefGoogle Scholar
  31. Inui, T., Carter, W., Pecoraro, R., Pearlman, R., & Dohan, J. (1980). Variations in patient compliance with common long-term drugs. Medical Care, 18, 986–993.PubMedCrossRefGoogle Scholar
  32. Inui, T., Yourtee, E., & Williamson, J. (1976). Improved outcomes in hypertension after physician tutorials: A controlled trial. Annals of Internal Medicine, 84, 646–651.PubMedCrossRefGoogle Scholar
  33. Janis, I., & Mann, L. (1977). Decision making: A psychological analysis of conflict, choice, and commitment. New York: Free Press.Google Scholar
  34. Janz, N., & Becker, M. (1984). The health belief model: A decade later. Health Education Quarterly, 11, 1–47.PubMedCrossRefGoogle Scholar
  35. Janz, N., Becker, M., Kirscht, J., Eraker, S., Billi, J., & Woolliscroft, J. (1986). Evaluation of a minimal-contact smoking cessation intervention in an outpatient setting. Unpublished manuscript.Google Scholar
  36. Kasl, S., & Cobb, S. (1966). Health behavior, illness behavior, and sick role behavior. Archives of Environmental Health, 12, 246–266, 531-541.PubMedCrossRefGoogle Scholar
  37. Kegeles, S. (1980). The health belief model and personal health behavior. Social Science and Medicine, 14C, 227–229.Google Scholar
  38. Kegeles, S., & Lund, A. (1982). Adolescents’ health beliefs and acceptance of a novel preventive dental activity: Replication and extension. Health Education Quarterly, 9, 192–208.PubMedCrossRefGoogle Scholar
  39. Kelly, P. (1979). Breast self-examination: Who does them and why. Journal of Behavioral Medicine, 2, 31–38.PubMedCrossRefGoogle Scholar
  40. King, J. (1982). The impact of patients’ perceptions of high blood pressure on attendance at screening: An extension of the health belief model. Social Science and Medicine, 16, 1079–1091.PubMedCrossRefGoogle Scholar
  41. Kirscht, J. (1974). The health belief model and illness behavior. Health Education Quarterly, 2, 387–408.Google Scholar
  42. Kirscht, J. (1983). Preventive health behavior: A review of research and issues. Health Psychology, 2, 277–301.CrossRefGoogle Scholar
  43. Kirscht, J., Becker, M., Haefner, D., & Maiman, L. (1978). Effects of threatening communications and mothers’ health beliefs on weight change in obese children. Journal of Behavioral Medicine, 1, 147–157.PubMedCrossRefGoogle Scholar
  44. Kirscht, J., Janz, N., & Becker, M. (1986). Psychosocial predictors of change in cigarette smoking. Unpublished manuscript.Google Scholar
  45. Kirscht, J., & Rosenstock, I. (1979). Patients’ problems in following recommendations of health experts. In G. Stone, F. Cohen, & N. Adler (Eds.), Health psychology (pp. 189–215). San Francisco: Jossey-Bass.Google Scholar
  46. Langlie, J. (1977). Social networks, health beliefs, and preventive health behavior. Journal of Health and Social Behavior, 18, 244–260.PubMedCrossRefGoogle Scholar
  47. Larson, E., Bergman, J., Heidrich, F., Alvin, B., & Schneeweiss, R. (1982). Do postcard reminders improve influenza vaccination compliance? Medical Care, 20, 639–648.PubMedCrossRefGoogle Scholar
  48. Lau, R., & Hartman, K. (1983). Common sense representations of common illnesses. Health psychology, 2, 167–185.CrossRefGoogle Scholar
  49. Leavitt, F. (1979). The health belief model and utilization of ambulatory care services. Social Science and Medicine, 13A, 105–112.Google Scholar
  50. Leventhal, H. (1971). Fear appeals and persuasion: The differentiation of a motivational construct. American Journal of Public Health, 61, 1208–1224.PubMedCrossRefGoogle Scholar
  51. Leventhal, H., Meyer, D., & Nerenz, D. (1980). The common sense representation of illness danger. In S. Rachman (Ed.), Medical psychology (Vol. II, pp. 7–29). New York: Pergamon Press.Google Scholar
  52. Leventhal, H., Zimmerman, R., & Gutmann, M. (1984). Compliance: A self-regulation perspective. In D. Gentry (Ed.), Handbook of behavioral medicine (pp. 369–436). New York: Guilford Press.Google Scholar
  53. Mechanic, D. (1978). Medical sociology (2nd ed.). New York: Free Press.Google Scholar
  54. Oldridge, N. (1982). Compliance and exercise in primary and secondary prevention of coronary heart disease: A review. Preventive Medicine, 11, 56–70.PubMedCrossRefGoogle Scholar
  55. Oliver, R., & Berger, P. (1979). A path analysis of preventive health care decision models. Journal of Consumer Research, 6, 113–122.CrossRefGoogle Scholar
  56. Palmer, D., & King, R. (1983). Attitude toward hepatitis vaccination among high-risk hospital employees. Journal of Infectious Diseases, 147, 1120–1121.PubMedCrossRefGoogle Scholar
  57. Pirie, P., Elias, W., Wackman, D., Jacobs, D., Murray, D., Mittelmark, M., Luepker, R., & Blackburn, H. (1986). Characteristics of participants and nonparticipants in a community cardiovascular risk factor screening: The Minnesota Heart Health Program. American Journal of Preventive Medicine, 2, 20–25.PubMedGoogle Scholar
  58. Rogers, R. (1975). A protection motivation theory of fear appeals and attitude change. Journal of Psychology, 91, 93–114.CrossRefGoogle Scholar
  59. Ronis, D., & Harel, Y. (1986). Health beliefs and breast examination behaviors: Analyses of linear structural relations. Unpublished manuscript.Google Scholar
  60. Rosenstock, I. (1974a). Historical origins of the health belief model. Health Education Monographs, 2, 328–335.Google Scholar
  61. Rosenstock, I. (1974b). The health belief model and preventive health behavior. Health Education Monographs, 2, 354–386.Google Scholar
  62. Rosenstock, I., & Kirscht, J. (1979). Why people seek health care. In G. Stone, F. Cohen, & N. Adler (Eds.), Health psychology (pp. 161–188). San Francisco: Jossey-Bass.Google Scholar
  63. Rundall, T., & Wheeler, J. (1979a). The effect of income on use of preventive care: An evaluation of alternative explanations. Journal of Health and Social Behavior, 20, 397–406.PubMedCrossRefGoogle Scholar
  64. Rundall, T., & Wheeler, J. (1979b). Factors associated with utilization of the swine flu vaccination program among senior citizens. Medical Care, 17, 191–200.PubMedCrossRefGoogle Scholar
  65. Safer, M., Tharps, Q., Jackson, T., & Leventhal, H. (1979). Determinants of three stages of delay in seeking care at a medical care clinic. Medical Care, 17, 11–29.PubMedCrossRefGoogle Scholar
  66. Simon, K., & Das, A. (1984). An application of the health belief model toward educational diagnosis for VD education. Health Education Quarterly, 11, 403–418.PubMedCrossRefGoogle Scholar
  67. Stone, G. (1979). Psychology and the health system. In G. Stone, F. Cohen, & N. Adler (Eds.), Health psychology (pp. 41–75). San Francisco: Jossey-Bass.Google Scholar
  68. Strecher, V., Becker, M., Kirscht, J., Eraker, S., & Graham-Tomasi, R. (1985). Psychosocial aspects of changes in cigarette-smoking behavior. Patient Education and Counseling, 7, 249–262.PubMedCrossRefGoogle Scholar
  69. Strecher, V., DeVellis, B., Becker, M., & Rosenstock, I. (1986). The role of self-efficacy in achieving health behavior change. Health Education Quarterly, 13, 73–92.PubMedCrossRefGoogle Scholar
  70. Sutton, S. (1982). Fear-arousing communications: A critical examination of theory and research. In J. Eiser (Ed.), Social psychology and behavioral medicine (pp. 303–337). New York: Wiley.Google Scholar
  71. Sutton, S., & Eiser, J. (1984). The effect of fear-arousing communications on cigarette smoking: An expectancy-value approach. Journal of Behavioral Medicine, 7, 13–33.PubMedCrossRefGoogle Scholar
  72. Tanner, J., Cockerham, W., & Spaeth, J. (1983). Predicting physician utilization. Medical Care, 21, 360–369.PubMedCrossRefGoogle Scholar
  73. Turk, D., Litt, M., Salovey, P., & Walker, J. (1985). Seeking urgent pediatric treatment: Factors contributing to frequency, delay, and appropriateness. Health Psychology, 4, 43–59.PubMedCrossRefGoogle Scholar
  74. Velicer, W., DiClemente, C., Prochaska, J., & Brandenburg, N. (1985). Decisional balance measures for assessing and predicting smoking status. Journal of Personality and Social Psychology, 48, 1279–1289.PubMedCrossRefGoogle Scholar
  75. Weinberger, M., Greene, J., Mamlin, J., & Jerin, M. (1981). Health beliefs and smoking behavior. American Journal of Public Health, 71, 1253–1255.PubMedCrossRefGoogle Scholar
  76. Weisenberg, M., Kegeles, S., & Lund, A. (1980). Children’s health beliefs and acceptance of a dental preventive activity. Journal of Health and Social Behavior, 21, 59–74.PubMedCrossRefGoogle Scholar
  77. Wurtele, S., Roberts, M., & Leeper, J. (1982). Health beliefs and intention: Predictors of return compliance in a tuberculosis detection drive. Journal of Applied Social Psychology, 12, 128–136.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1988

Authors and Affiliations

  • John P. Kirscht
    • 1
  1. 1.School of Public HealthUniversity of MichiganAnn ArborUSA

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