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Understanding Health Behavior: The Health Belief Model’s Application in University Settings
The Health Belief Model & University Students The Health Belief Model (HBM) is a method that scientists use to predict different health behaviors. It all started in the 50s when researchers were trying to explain why a large number of individuals were not very receptive to participating in a program to prevent and detect infectious diseases. What motivates people to make decisions of this magnitude? Well, this is the outcome of how the population perceives their environment. People usually take into consideration knowledge, attitudes, beliefs, experiences, skills, culture, and even religious habits to make healthy or harmful choices in their lives. The purpose of this paper is to discuss the four perceptions serving as the primary constructs of the Health Belief Model targeting university students.
Let us use the example of sexually transmitted diseases. According to the World Health Organization, more than 1 million sexually transmitted infections (STIs) are acquired every day worldwide. Generally, most of the STIs have no symptoms or only mild symptoms that may not be recognized. Sexually transmitted diseases are preventable. The Centers for Disease Control and Prevention stated that nearly half of the 20 million new sexually transmitted infections diagnosed each year are among young people aged 15–24 years. Having unprotected sexual activities should be a reason to visit a physician, even when there are no symptoms. People tend to think that just because they feel right, they are healthy. It seems like common sense, but for many individuals, other variables are influencing their decisions.
Perceived Severity and Susceptibility: Influences on Personal Beliefs and Health Choices
Perceived Severity refers to how dangerous an individual believes the consequences of developing a health condition will be (Orji et al. (2012). Based on the previous definition, a young adult or university student is more likely to take action to prevent sexually transmitted diseases if she/he believes that the adverse repercussions resulting from the disease represent serious consequences. Some of those consequences could be death, pain, family or social issues, and emotional relationship concerns. While the perception of seriousness is usually based on medical knowledge, it may come from beliefs an individual has about the consequences of an illness.
For example, let us imagine that there is a university student named Henry who got gonorrhea from unprotected sex. Henry had a conversation with a friend who had the same sexually transmitted infection, and he told him that the use of antibiotics for seven days was the ideal treatment. It is not a big deal, he said. In this case, Henry’s perception of the gonorrhea infection might be that it is not a severe disease. We have to mention that even in this modern world, there are countries where buying antibiotics without a medical prescription is usual. Henry can visualize the situation as unimportant.
On the other hand, what could motivate Henry to adopt a healthier behavior, such as practicing safer sex? Perceived susceptibility is one of the most powerful perceptions prompting individuals to start making healthy choices (Hayden,(2014). The greater the perceived risk, the higher the chances of engaging in practices to decrease the risk. Many university students are choosing casual sexual relationships, saving money and time, and avoiding emotional attachment (Downing-Matibag & Geisinger (2009). Many of those sexual encounters involve alcohol and several intimate behaviors that could end in unwanted pregnancies and sexually transmitted diseases. Understanding the risk-taking within unsafe sexual practices and the consequences of sexually transmitted infections is essential to establish what we call perceived susceptibility.
Perceived Benefits, Barriers, and Campus Insights: Shaping Health Choices Among University Students
A study involving 71 college students at Iowa State University in 2009 demonstrated that the Health Belief Model could serve as a useful tool for understanding sexual risk-taking during ‘hooking up’ or casual dating (Downing-Matibag et al. (2009). It also offers recommendations to develop prevention programs on university campuses (Downing-Matibag et al. (2009). The construct of Perceived Benefits is defined as a person’s opinion of the value of new behavior in decreasing the risk of developing a disease (Hayden,(2014). In other words, it is the potential positive effect of health activity. Henry will not continue his old behavior if he can understand the benefits of protected sex. The use of condoms helps prevent and spread sexually transmitted infections (HIV, chlamydia, gonorrhea) and unwanted pregnancies, has no side effects, and is quite accessible.
In the same way, we have to discuss the term Perceived Barriers. According to (Hayden (2014), these are an individual’s perception of the difficulties in the way of adopting a new behavior. Conforming to the article ‘Barriers and enablers to sexual health service use among university students,’ despite the availability of sexual health services at university health centers to promote sexual health, many students avoid seeking care. Multi-level barriers and enablers are known to influence sexual health service use among university students and provide some insight into the low rates of service use (Cassidy et al. (2018).
An analysis conducted on 56 university students identified ten barriers and enablers to sexual health service use based on seven domains: knowledge, memory, attention and decision-making, social influences, environmental factors, beliefs about consequences, optimism, and emotions. Most of the students showed the following barriers: limited sexual knowledge and awareness, lack of clarity for LGBTQ students, visibility of sexual health services (prompts & reminders), health care provider interaction, peer influence, campus culture, accessibility of services, a period of exploration and experimentation, normalizing sexual health, stigma, and confidentiality Cassidy et al. (2018).
Empowering Behavior Change: The Health Belief Model in Health Education and Student Insights
In conclusion, the Health Belief Model is a cognitive model for explaining health risk behavior (Downing-Matibag et al. (2009). It can be used as a helpful approach when establishing health education programs or strategies. As stated by (Brown et al. (1991), the HBM revealed that people take preventive actions if they believe that they are susceptible to an adverse health outcome, the cost of incurring the adverse health outcome will be severe, the benefits of protection outweigh the costs, and they can undertake the necessary actions to protect themselves from the outcome.
Finally, in line with Downing-Matibag et al. (2009) experiment, university students stated that they knew how to prevent sexually transmitted infections during sexual intercourse. They also knew where they could purchase protective barriers such as condoms and how to use them. However, they were unaware when the protection was necessary (e.g., oral sex). The lack of knowledge sometimes tarnishes an individual’s judgment. In the end, individual beliefs or the appreciation of their environment are what determine behavior.
References
- Orji, R., Vassileva, J., & Mandryk, R. (2012). Towards an effective health interventions design: an extension of the health belief model. Online Journal of Public Health Informatics, 4(3), e9.
- Hayden, J. A., & Introduction, B. P. (2014). The Health Belief Model. In Introduction to Health Behavior Theory (2nd ed., pp. 24-32). Jones & Bartlett Learning.
- Downing-Matibag, T. M., & Geisinger, B. (2009). Hooking up and sexual risk taking among college students: A health belief model perspective. Qualitative Health Research, 19(9), 1196-1209.
- Cassidy, C., Steenbeek, A., & Lang, T. (2018). Barriers and enablers to sexual health service use among university students: a qualitative descriptive study using the theoretical domains framework and COM-B model. BMC Health Services Research, 18(1), 731.
- Brown, R. M., & Kandula, S. R. (1991). Developing a new strategy for tuberculosis control: Health Belief Model. The Family Physician, 24, 97-100.
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