Chapter 5

Health Belief Model (HBM)

*Figure 5-2 suggests that two constructs have an independent influence on health behavior: perceived threat and expected net gain of adopting a health behavior - likelihood of action determined by perceived gains - suggests that perceived threat directly influences the likelihood of engaging in the protective behavior - People are unlikely to act (adopt a health protective behavior) in absence of a clear expected net gain - inc the perceived value of benefits from action & dec the perceived barriers - likelihood of action construct= assesses the degree of motivation a person may have to engage in a health protective behavior - Cues to action= events, symptoms or reminders that encourage behavior - self efficacy= suggests that people will not try a new behavior unless they are confident that they can perform the behavior

Protection Motivation Theory (PMT)

*Figure 5-6 - at its core is the concept of perceived threat along with an analysis of rewards and costs for engaging in either maladaptive or adaptive responses (addressed reasoning more than HBM does) - When faced with fear-arousing stimuli, individuals can either adopt positive, adaptive responses to avoid the threat or, choose maladaptive, negative behaviors that ignore risk - use fear as a motivator for positive behavior - 2 appraisal processes: threat & coping - all four parts of PMT- severity, vulnerability, response efficacy and self-efficacy should be addressed to maximize the desired effect - if effective, we have protection motivation --> behavioral change

Extended Parallel Process Model (EPPM)

*Figure 5-9 - attempts to answer "How do individuals respond to fear-arousing communications?" - In many ways a communication theory more than a behavioral theory - If a fear appeal elicits a perceived threat, EPPM posits that individuals will either accept a fear appeal message and engage in a danger control process or reject a message and engage in a fear control process - For a fear appeal to be successful, it must increase not only a sense of perceived threat but also increase individual's sense of efficacy to successfully engage in recommended response

Fear appeals intro

Fear= chain reaction in the brain that starts when faced with a stressful stimulus and ends with the release of chemicals that cause your heart to race, your breathing to escalate and your muscles to energize (fight-or-flight response) - what people consider frightening varies - PH professionals hypothesized it might be possible to harness the power of instinctual fear response to change health risk behaviors - Ex: If people feared certain disease outcomes, they might take action to avoid them - To create an effective response a stimulus must be perceived as scary and the individual must believe they will be affected - theoretical construct= perceived threat is the combination of the perception of a scary stimulus and perceived vulnerability of the individual - this construct is inspiration for all fear appeals

HBM: Perceived Susceptibility

How likely someone believes they will acquire a disease or harmful state due to a certain behavior (how likely it is negative outcome to happen to you) - "How likely am I to experience this negative health outcome?"

HBM: Perceived Severity

The belief of how harmful a disease or harmful state will cause them due to a behavior (how severe would health outcome be) - "If this negative health outcome happened to me, how bad would it be?"

EPPM: Fear control process

characterized by an individual's belief that they are either unable to engage in recommended response or believe the response to be ineffective (individual is coping by controlling the fear rather than the threat)

PMT appraisal processes: coping appraisal

includes the response efficacy of the recommended behavior-- an evaluation of how effective the behavior will be in protecting the individual from harm - factors= costs of the adaptive response, perceived self-efficacy to accomplish the behavior, past experiences, env factors, & personality variables

EPPM: Danger control process

individual will engage in strategies to avert the threat - manage the danger

PMT appraisal processes: threat appraisal

involves assessment of seriousness of a health threat by estimating probability and severity of a negative outcome if no action is taken - rewards, both intrinsic and extrinsic, play a role in the threat appraisal process - Considering the severity and vulnerability of negative outcomes reduces attractiveness of rewards

EPPM: message components

perceived threat (susceptibility & severity) perceive efficacy (self- & response-) - The extent to which these variables are used successfully in message design is theorized to impact how individuals process those messages

EPPM: positive & negative outcomes

positive= protection motivation, message acceptance, danger control negative= defensive motivation, message rejection, fear control

EPPM: defensive avoidance

when an individual blocks further thoughts or feelings about the health threat or avoids exposing themselves to further information about the topic as a coping mechanism to deal with fear