What Is the Health Belief Model?

The Health Belief Model explains why people decide to take—or avoid—health-related action. It begins with a simple observation: people do not respond to health information only because facts are available. They respond according to what they believe about risk, seriousness, benefits, barriers, and their own ability to act.

A person may know that exercise lowers heart disease risk, that vaccines reduce illness, or that screening can detect disease early. Yet knowledge alone does not guarantee action. The Health Belief Model helps explain the gap between knowing and doing by examining the beliefs that make a health threat feel urgent, manageable, or easy to ignore.

The model is especially useful in health psychology and public health because it identifies practical points for intervention. If someone does not believe they are at risk, perceived susceptibility must be addressed. If the behavior feels too costly, perceived barriers matter. If they believe the action will help but doubt their ability to follow through, self-efficacy becomes central.

In this way, the Health Belief Model is not just a theory of health behavior. It is a framework for understanding how people interpret health risks, weigh action against obstacles, and decide whether change feels possible.

History of the Health Belief Model

The Health Belief Model (HBM) was developed in the 1950s by a group of social psychologists at the U.S. Public Health Service. The primary developers were Irwin M. Rosenstock, Godfrey M. Hochbaum, S. Stephen Kegeles, and Howard Leventhal. The Health Belief Model (HBM) was first published in the context of studies on the uptake of tuberculosis X-ray screening by Godfrey M. Hochbaum in 1958 (Abraham & Sheeran, 2007).

The model has since been refined and expanded upon, but the initial research by Hochbaum laid the groundwork for what would become one of the most influential theories in health behavior research. They created the model to explain and predict health-related behaviors, especially regarding the uptake of health services. The HBM has since become one of the most widely used and well-known theories in health behavior research.

Core Constructs of the Health Belief Model

The Health Belief Model explains health behavior by focusing on the beliefs that shape whether a person feels motivated and able to act. Charles Abraham and Paschal Sheeran explain that beliefs are central to the model because they are “enduring individual characteristics which influence behavior and are potentially modifiable” (Abraham & Sheeran, 2007).

In other words, the model does not assume that people act on medical facts alone. People act on how they interpret those facts: whether they feel personally vulnerable, whether the condition seems serious, whether the recommended action seems useful, whether barriers feel manageable, and whether they believe they can actually follow through.

Perceived Threat: Susceptibility and Seriousness

Two core beliefs shape a person’s sense of perceived threat: perceived susceptibility and perceived seriousness.

Perceived susceptibility refers to a person’s belief about their own risk. Someone who believes they are likely to get the flu may be more inclined to get vaccinated. Someone who believes heart disease is a distant concern may ignore preventive advice, even if the general risk is real.

Perceived seriousness refers to how severe a person believes the health condition and its consequences may be. These consequences may be medical, such as pain, disability, or death. They may also be social or practical, such as effects on work, family life, independence, or relationships.

Together, susceptibility and seriousness shape whether the health issue feels personally meaningful. If a person believes, This could happen to me and the consequences would matter, the perceived threat becomes stronger. If either belief is weak, motivation may remain low.

Modifying variables also influence this process. Age, gender, ethnicity, socioeconomic status, personality, prior experience with illness, and knowledge about a disease can all shape how people interpret risk and severity. A 21-year-old may perceive heart disease very differently than a 65-year-old experiencing shortness of breath while walking. The medical facts may matter, but perception determines how those facts enter the person’s decision-making.

Perceived Benefits and Barriers

Health behavior also depends on how people weigh the expected benefits of action against the perceived costs. Perceived benefits refer to the belief that a recommended behavior will actually reduce risk or lessen the seriousness of a condition. Perceived barriers refer to the obstacles, costs, fears, inconveniences, or practical limitations that make action difficult.

This balance is deeply subjective. Neuroscientist V. S. Ramachandran explains, “Perception is an actively formed opinion of the world rather than a passive reaction to sensory input from it” (Ramachandran, 2011). The same health recommendation may feel simple and reasonable to one person but overwhelming to another.

For example, a person may believe that exercise and healthier eating could reduce their risk of heart disease. Those are perceived benefits. But if they also anticipate cost, fatigue, embarrassment, lack of time, limited access to safe walking spaces, or past failure, the perceived barriers may outweigh the benefits. In the Health Belief Model, people are more likely to act when the benefits feel meaningful and the barriers feel manageable.

This is why health professionals must do more than explain why a behavior is good. They must also understand what makes the behavior difficult. A person may not need more information. They may need transportation, reminders, social support, affordable care, a simpler plan, or help believing that change is possible.

Self-Efficacy: Believing Action Is Possible

Self-efficacy refers to a person’s confidence in their ability to perform and sustain a health behavior. It was added to the Health Belief Model to acknowledge the role of personal agency in behavior change. Albert Bandura explains, “The strength of people’s convictions in their own effectiveness is likely to affect whether they will even try to cope with given situations” (Bandura, 1977, p. 193).

This matters because recognizing a threat is not enough. A person may believe they are at risk, believe the condition is serious, and believe the recommended action would help—but still fail to act if they do not believe they can carry it out.

Someone may understand the benefits of exercise but doubt their ability to maintain a routine. Another person may know that diet changes could improve health but feel overwhelmed by planning, cost, habits, family patterns, or past discouragement. Low self-efficacy turns a reasonable health recommendation into something that feels unreachable.

Effective interventions often strengthen self-efficacy by making action smaller, clearer, and more achievable. Instead of simply telling someone to “exercise more,” an intervention might begin with a ten-minute walk three times a week, a specific plan, social encouragement, and early experiences of success.

Cues to Action

Even when the right beliefs are in place, people often need a prompt to move from awareness to action. Abraham and Sheeran wrote that “the model proposes that cues to action can activate health behaviour when appropriate beliefs are held. These ‘cues’ include a diverse range of triggers including individual perceptions of symptoms, social influence and health education campaigns” (Abraham & Sheeran, 2007).

Cues to action may be internal or external. Internal cues include symptoms, pain, shortness of breath, fatigue, or noticing a change in the body. External cues include a physician’s recommendation, a reminder letter, a public health campaign, a family member’s illness, or a conversation with a trusted friend.

These cues matter because beliefs do not influence behavior unless they become active in attention. Edsel L. Beja Jr. explains that “focused thinking makes a focal item salient, which invokes strong emotions” (Beja, 2014). A cue brings the health concern into working memory. It makes risk, seriousness, benefits, barriers, and self-efficacy emotionally available in the moment of decision.

For example, a person may vaguely know that smoking is dangerous. But an episode of shortness of breath, a doctor’s warning, or a friend’s diagnosis may make the threat suddenly salient. The cue does not create the entire belief system, but it can activate it.

How the Constructs Work Together

The Health Belief Model is most useful when its constructs are viewed together. A person is more likely to take health-related action when they believe they are personally at risk, believe the condition is serious, believe the recommended action will help, perceive barriers as manageable, receive a cue to act, and feel capable of following through.

The model also explains why health behavior often breaks down. A person may understand the seriousness of a disease but feel personally invulnerable. Another may recognize the risk but see too many barriers. Another may believe the behavior would help but doubt their ability to sustain it. Still another may hold all the relevant beliefs but never receive a strong enough cue to act.

This is the practical strength of the Health Belief Model. It helps health professionals move beyond the assumption that people simply need more information. Instead, it asks a more useful set of questions: What does this person believe about risk? What makes the action feel worthwhile? What makes it difficult? What prompt might move concern into action? And what would help this person believe they can succeed?

The Health Belief Model in Action

Example 1: Cancer Screening

A successful intervention goal based on the Health Belief Model (HBM) would be to increase participation in health screenings. For instance, in Australia, public officials designed and implemented interventions, using the HBM framework, to encourage adults to participate in bowel cancer screening programs. Despite the availability of screening services, participation was low. By applying the HBM framework they improved participation rates (Nortje, 2024).

A person may ignore a recommended cancer screening because they do not feel personally at risk. In Health Belief Model terms, perceived susceptibility is low. If they also believe the disease is unlikely to be serious or treatable, perceived severity and perceived benefits may also be weak.

A stronger intervention would not simply say, “Get screened.” It would address the belief structure behind the delay:

• Susceptibility: Explain who is at risk and why screening applies to this person.
• Severity: Clarify the consequences of late detection without exaggerating fear.
• Benefits: Show how early detection improves treatment options.
• Barriers: Reduce obstacles such as cost, transportation, confusion, or embarrassment.
• Cues to action: Send reminders, physician prompts, or community messages.
• Self-efficacy: Make the next step simple: where to go, what to expect, and how to schedule.

This is why the model remains useful in public health. It translates an abstract goal—“increase screening”—into specific beliefs and barriers that can be addressed.

Example 2: Exercise and Heart Disease Risk

Consider someone with a family history of heart disease who knows exercise is beneficial but still avoids regular activity. The Health Belief Model would ask: Does the person believe they are personally vulnerable? Do they believe heart disease is serious? Do they believe exercise will help? What barriers feel larger than the benefits?

The barrier may not be ignorance. It may be fatigue, embarrassment, lack of time, physical discomfort, past failure, or low confidence. In that case, a useful intervention would pair education with practical support: a modest walking plan, social support, reminders, and small early successes that build self-efficacy (Ramos et al., 2021).

This example shows why the HBM is more than a list of beliefs. It helps identify where motivation is breaking down. The person may believe the risk is real and the benefit is clear, but still fail to act if the barriers feel too high or the behavior feels impossible to sustain.

Applying the Health Belief Model in Health Promotion

The Health Belief Model is most useful when it moves beyond explanation and becomes a guide for intervention. It helps health professionals identify why people may not act on a health recommendation, even when the recommendation appears reasonable from the outside.

Rather than assuming that people simply need more information, the model asks where motivation is breaking down. Does the person believe the risk applies to them? Do they understand the seriousness of the condition? Do they believe the recommended action will help? Are practical, emotional, financial, or cultural barriers making the action difficult? Do they feel capable of following through?

This approach allows health promotion efforts to become more precise. A campaign aimed at increasing cancer screening, for example, may need to address fear, cost, embarrassment, transportation, low perceived risk, or lack of confidence in the next step. A message that only says “get screened” may miss the belief or barrier that is actually preventing action.

Applied well, the Health Belief Model encourages interventions that are specific, humane, and practical. It reminds us that people make health decisions through a mixture of perceived risk, emotional meaning, practical obstacles, social context, and confidence in their ability to change.

Human Behavior Is Not Always Rational

One of the main critiques of the Health Belief Model is that it can make health behavior appear more rational and deliberate than it often is. The model maps beliefs—risk, severity, benefits, barriers, cues, and self-efficacy—but human beings do not always move from belief to action in an orderly sequence.

Often, cognition arrives after behavior. We act impulsively, emotionally, habitually, or socially, and then explain the behavior afterward. We may confabulate reasons that sound rational even when the original action emerged from stress, appetite, fatigue, fear, identity, or the immediate pull of the environment. Our rationality is bounded by human limitation.

Antonio Damasio, the Portuguese neuroscientist, explains that “irrationality is the enemy to prediction.” Yet he also adds that “even if our reasoning strategies were perfectly tuned, it appears, they would not cope well with the uncertainty and complexity of personal and social problems” (Damasio, 2005).

This is where the clean flow charts of health behavior meet the messy realities of lived experience. A person may know they should eat better. They may know heart disease runs in the family. They may have the money, time, knowledge, and ability to act differently. And still, after a long week, they may order the double cheeseburger, wash it down with a couple pints, and promise themselves they will begin again on Monday.

This does not make the Health Belief Model useless. It makes humility necessary. The model can clarify important beliefs and barriers, but it should not be used as if health behavior were only a matter of rational calculation. Used alongside other theories—such as social cognitive theory, the theory of planned behavior, protection motivation theory, or the transtheoretical model—it contributes to a more complete understanding of why people change, why they resist change, and why good intentions so often collide with human complexity.

A Few Words by Psychology Fanatic

In conclusion, the Health Belief Model (HBM) offers a comprehensive framework for understanding the multifaceted nature of health behavior. It underscores the importance of individual beliefs and perceptions in the decision-making process related to health actions. By considering factors such as perceived susceptibility, perceived severity, perceived benefits, perceived barriers, self-efficacy, and cues to action, the HBM provides valuable insights. These cognitions help explain why people choose to engage in health-promoting behaviors—or why they may fail to do so.

As we navigate an ever-evolving healthcare landscape, the HBM remains a vital tool for health professionals seeking to design effective interventions. It encourages a holistic approach that not only educates individuals about health risks and benefits but also empowers them. The HMB model instills confidence in individuals to take control of their health outcomes.

Whether addressing chronic diseases, infectious diseases, or preventive health measures, the HBM reminds us that at the heart of health behavior change lies the individual’s perception. By enhancing our understanding, we can better support individuals to make informed decisions. Our knowledge can be the gateway for ourselves and others to experience healthier lives.

The journey to optimal health is a personal one. The HBM serves as a guide to help individuals understand the psychological pathways that can lead to more positive health choices. It is a testament to the power of belief in shaping our health destinies.

Last Update: August 21, 2025

Associated Concepts

• Theory of Planned Behavior (TPB): This theory suggests that behavioral intentions drive behavior. Intentions are a function of an individual’s attitude toward the behavior, the subjective norms surrounding the performance of the behavior, and the individual’s perception of control over the behavior.
• Theory of Reasoned Action (TRA): A precursor to the TPB, this theory posits that individuals’ behavioral intentions are shaped by their attitudes toward the behavior and subjective norms.
• Social Cognitive Theory (SCT): This theory emphasizes the role of observational learning, social experience, and reciprocal determinism in the development of health behaviors.
• Diffusion of Innovations Theory: This theory explains how new ideas and behaviors spread within a society or group. It provides insights into how health behaviors can be adopted at a community level
• Transtheoretical Model (TTM): Also known as the Stages of Change Model, this model proposes that individuals go through a series of stages when changing a behavior. These stages go from precontemplation to maintenance.
• Protection Motivation Theory (PMT): This theory focuses on how people are motivated to protect themselves from harm. It explains that individuals consider perceived severity and susceptibility to a threat, the efficacy of the protective behavior, and their self-efficacy to perform it. This theory shares many elements with the Health Belief Model (HBM).
• Precaution Adoption Process Model (PAPM): This model describes how a person comes to the decision to take action and how they translate that decision into action.

References:

Abraham, Charles; Sheeran, Paschal (2007). The Health Belief Model. In: Susan Ayers, Andrew Baum, Chris McManus, Stanton Newman, Kenneth Wallston, John Weinman, and Robert West (eds.), Cambridge Handbook of Psychology, Health and Medicine. Cambridge University Press. ISBN: 9780521605106
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Bandura, Albert (1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84(2), 191-215. DOI: 10.1037/0033-295X.84.2.191
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Beja, Edsel L. (2014). The Focusing Illusion and Happiness: Evidence Using College Basketball Championship. Social Indicators Research, 121(3), 873-885. DOI: 10.1007/s11205-014-0667-x
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Nortje, Alicia (2024). What Is the Health Belief Model? An Updated Look. Positive Psychology. Published: 4-12-2024; Accessed: 5-31-2024. Website: https://positivepsychology.com/health-belief-model/
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Ramachandran, V. S. (2011). The Tell-Tale Brain: A Neuroscientist’s Quest for What Makes Us Human. W. W. Norton & Company; Reprint edition. ISBN: 978-0-393-34062-4
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Ramos, Athena K.; Carvajal-Suarez, Marcela; Trinidad, Natalia; Quintero, S. A.; Molina, D.; Johnson-Beller, R.; Rowland, Sheri A. (2021). Health and well-being of Hispanic/Latino meatpacking workers in Nebraska: An application of the Health Belief Model. Workplace Health & Safety, 69(12), 564–572. DOI: 10.1177/21650799211016907
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