Health Belief Model Research Articles (Page 1)

Information sources used by pregnant women to make healthy lifestyle choices: A qualitative analysis.

Tuberculosis (TB) disproportionately affects non-US-born people from TB-endemic countries. Previous studies demonstrated that educational interventions effectively increased knowledge, perception, and latent tuberculosis infection (LTBI) screening in at-risk people. Given the high prevalence of LTBI and active TB cases and the large proportion of non-US-born individuals with low LTBI awareness residing in California, this study sought to evaluate the impact of video-based LTBI education in this population. Using a pre-post study design, we evaluated the impact of a 5-minute LTBI educational video on participants using the Health Belief Model (HBM) constructs. We enrolled 84 non-US-born participants during the study period. Participants first completed the pre-survey, which consisted of the HBM LTBI Survey, followed by a demographic survey. Participants then watched the educational intervention video, followed by the post-survey, which consisted of the HBM LTBI Survey. This study found a significant increase in perceived susceptibility, t (83) = 8.82, p < 0.001, perceived severity, t (83) = 2.06, p = 0.043, perceived benefits, t (83) = 3.33, p < 0.001, and behavioral intentions to screen for TB, t (82) = 3.99, p < 0.001, as well as a significant decrease in perceived barriers, t (83) = -3.38, p < 0.001. This study also found that overall, the HBM significantly predicted behavioral intentions to engage in TB screening, F (7, 62) = 10.22, p < 0.001. We found that a health education video improved the self-reported education, awareness, and desire for screening for LTBI in non-US-born populations living in California. Future studies should evaluate whether such interventions result in a higher uptake of LTBI screening and treatment.

Purpose This study aims to investigate the older population’s knowledge of lung cancer in relation to their smoking status and health beliefs regarding lung cancer. Design/methodology/approach A cross-sectional, quantitative, descriptive approach was used. Based on the health belief model (HBM), 384 older people were randomly selected for distribution of the Lung Cancer and Smoking Survey. Findings The results showed that 76.1 percent of the elderly were current smokers. Also, the majority of participants (77.1%) knew that lung cancer was common. 77.5% disagreed that side-stream smoking contributed to the incidence of lung cancer. Merely 67.1% of them agreed that lung cancer is more common among males. In addition, 70% of participants disagreed that lung cancer could be easily cured. Practical implications Developing targeted educational materials and counseling sessions tailored to the specific needs and perceptions of current smokers, former smokers and nonsmokers regarding lung cancer knowledge and health beliefs, also help nurses collaborate with healthcare providers to ensure that elderly individuals receive comprehensive care that addresses their lung cancer knowledge, health beliefs and smoking status. Also, organize community outreach programs and support groups for elderly individuals to share experiences, receive peer support and access resources related to lung cancer knowledge and smoking cessation. Originality/value The HBM is a valuable tool for assessing and understanding elderly individuals’ perceptions of smoking and lung cancer

Background/objectives Breast cancer remains one of the leading health concerns for women worldwide, while methods promoting early detection, such as breast self-examination (BSE), are still insufficiently integrated into preventive practices. The aim of this study was to explore health beliefs related to BSE and the factors influencing them among female students of the Faculty of Health Sciences at the University of Pécs, using the Health Belief Model (HBM). Methods A quantitative, cross-sectional study was conducted with the participation of 251 students, who assessed perceived susceptibility, severity, benefits, barriers, self-efficacy, and health motivation regarding BSE using the Champion Health Belief Model Scale (CHMBS). Results The study found that 50.2% of students performed BSE regularly, 41.8% occasionally, and 8% never. A family history of breast cancer, especially cases in-volving grandmothers, was significantly associated with the practice of breast self-examination (χ 2 = 4.437, p = 0.035). Self-efficacy was the strongest predictor (OR = 1.67; p &amp;lt; 0.001), while perceived barriers (OR = 0.68; p = 0.012), perceived severity (OR = 1.32; p = 0.003), and BSE knowledge (OR = 1.23; p = 0.035) also influenced engagement. Students with higher self-efficacy (χ 2 = 12.875, p = 0.012) and better knowledge of breast cancer prevention were more likely to practice BSE. Information from gynecologists and family played a crucial role in BSE adherence. Conclusion This study offers a new perspective for professionals by emphasizing the need for targeted health education programs that focus on strengthening self-efficacy and reducing perceived barriers. Our findings are of significant public health importance, as they support the integration of structured BSE education into university curricula, thereby fostering the development of health-conscious behaviors that promote early detection among young women.

ABSTRACT Introduction Internal migrant girls, known as Kayayei , are among Ghana's most vulnerable urban populations, facing elevated sexual health risks due to economic insecurity and limited access to reproductive services. Guided by the Health Belief Model (HBM), this study examined barriers, enablers, and willingness to use condoms among sexually active Kayayei . Methods A mixed‐methods design was employed. Quantitative data were collected from 400 Kayayei using structured questionnaires, complemented by 40 in‐depth interviews (IDIs), two focus group discussions (FGDs) with 24 participants, and 20 key informant interviews (KIIs) involving market leaders, Kayayei association representatives, and child protection officers. Quantitative data were analysed descriptively, and qualitative data underwent thematic analysis. Results Only 25.5% of Kayayei reported condom use, while 74.5% did not, indicating low and inconsistent usage. Barriers included partner resistance, limited access, stigma, low self‐efficacy, and misconceptions about condom safety. Enablers comprised peer influence, prior sexual health education, and access to youth‐friendly services. Most expressed willingness to use condoms if freely available. Conclusions Condom use among Kayayei is shaped by psychological and structural determinants. Interventions combining behavioural change communication with economic and social support are vital to increase condom uptake and improve sexual health outcomes among Ghana's internal migrant girls.

Domestic waste collectors (DWCs) are exposed to occupational safety and health related morbidities and mortalities globally due to the non-use, improper use, and non-availability of personal protective equipment (PPE) in their jobs which endangers DWCs’ lives, safety, and well-being. The present study investigated the extent to which socio-cognitive determinants predicted PPE use among DWCs in the Ho municipality in the Volta Region in Ghana. A quantitative cross-sectional survey was conducted among DWCs (n = 344) in the Ho Municipality of Ghana to assess the socio-cognitive determinants of PPE use. The questionnaire consisted of 107 items that were informed by a literature review in previous qualitative research, and two theoretical frameworks explaining behavior (i.e., the Health Belief Model (HBM) and Reasoned Action Approach (RAA) and measured constructs such as perceived severity and susceptibility of work-related health risks, perceived benefits, and barriers, perceived norm, and self-efficacy towards PPE use. Partial least squares structural equation modeling (PLS-SEM) was used to evaluate the structural model describing the relationship between the socio-cognitive determinants and intention to use PPE, which was the main outcome measure. The integrated model explained 67% of the variance in PPE-use intention. Intention to use PPE was significantly positively and directly influenced by attitude (β = 0.174, p < 0.001), indicated cues to action (β = 0.500, p < 0.001), perceived rule enforcement by the management (β = 0.114, p < 0.05), and self-efficacy (β = 0.199, p < 0.01). The direct effect of subjective norms on intention to use PPE was not significant (β = 0.040, p = 0.396). Attitude in turn was significantly predicted by perceived severity (β = 0.244, p < 0.001), perceived benefits (β = 0.209, p < 0.01), and behavioral beliefs (β = 0.342, p < 0.001), whereas perceived barriers were significantly associated with self-efficacy (β = 0.377, p < 0.001). In conclusion, the current study successfully expanded the utility of HBM and RAA in assessing the socio-cognitive determinants of PPE use among DWCs in a developing economy. Thus, the findings highlight the combined influence of individual beliefs and organizational enforcement on DWCs’ motivation to use PPE. Interventions should pair hazard‑communication and self‑efficacy training with strict managerial enforcement to strengthen PPE compliance.

Introduction: Coronary artery disease (CAD) is the leading cause of death worldwide. Medication management is the priority for its secondary prevention. However, medication adherence was sub-optimal among older adults with CAD, who had greater challenges than younger adults, due to more concerns about the side-effects, forgetfulness and polypharmacy. Comprehensive and rigorously designed educational programmes are needed to improve their medication adherence. Aim: To evaluate the effects of a Health Belief Model based educational programme in improving medication adherence and other related outcomes among older adults with CAD. Methods: This is a two-arm, single-blind, pilot randomised controlled trial, conducted from March to May 2025 in the cardiology department of a tertiary hospital, adopting convenience sampling. The intervention group received a Health Belief Model based educational programme and usual care, and the control group received usual care only. Feasibility (recruitment, completion, attrition rate) and acceptability (semi-structured interviews and satisfaction scales) were assessed. Preliminary effects were measured at immediate post-intervention in terms of the level of medication adherence, perceived benefits and concerns about medications, medication self-management capacity, self-efficacy of medication taking, and health-related quality of life. Between group comparisons were analysed by Mann-Whitney U test, with Hedges’ g effect size calculated by changing scores. Qualitative data were analysed via content analysis. Results: A total of 40 older adults with CAD were recruited, with a 44.9% recruitment and 2.5% attrition rate. In the intervention group, 85% participants attended all sessions. Three categories emerged in the interviews, including perceived benefits and advantages of the intervention, and suggestions for improvement. Significant improvements in the intervention group were observed in medication adherence and perceptions about the benefits of medications (Hedge’s g=0.79 and 1.19), comparing with the control group. The intervention group demonstrated greater improvement in medication self-management capacity and self-efficacy (Hedge’s g=0.62 and 0.46), and greater reduction in the concerns about medications (Hedge’s g=-0.56). Conclusion: The educational programme was feasible and acceptable for older adults with CAD. A large scale randomised controlled trial will be conducted to examine the longer-term effect of the programme.

BackgroundThe COVID-19 vaccine hesitancy continuum reflects an individual decision-making process regarding vaccination, ranging from fully willing to accept the vaccine to outright refusal. This study assessed COVID-19 vaccine hesitancy and compared the explanatory power of selected psycho-behavioral models for its variability among adults living in Southwest Ethiopia.MethodsA community-based cross-sectional study was conducted in Southwest Ethiopia from January 1 to 15, 2022. The calculated sample size was 879. A multistage sampling technique was used to select study participants. Data were collected using an interviewer-administered questionnaire comprising four sections: socio-demographic characteristics, COVID-19-related covariates, psycho-behavioral constructs, and a vaccine hesitancy scale. The data were entered into Epi-Data, and analysis was performed using Python in Jupyter Notebook. Descriptive statistics and hierarchical multiple linear regression were performed to compare the predictive ability of four psycho-behavioral models: the health belief model (perceived susceptibility, severity, benefit, barrier, and cues to actions); the theory of planned behavior (attitudes, subjective norms, behavioral control, and anticipated regret); five psychological antecedents (confidence, complacency, constraints, calculation, and collective responsibility); and vaccine conspiracy belief (conspiracy related to infection and the vaccine). Model comparison was done using adjusted R-squared and model selection criteria.ResultsThe mean age of the participants was 31.63 ± 8.28, and 365 (44.3%) of them were female. The mean score of the COVID-19 vaccine hesitancy continuum was 5.11 ± 2.41. Among the respondents, 91 (11%) were fully willing to accept the COVID-19 vaccine, while 97 (11.8%) were completely resistant. The remaining 624 (77.18%) participants were hesitant to make a decision about vaccination.The vaccine conspiracy belief demonstrated the most predictive ability (adjusted R2 = 0.43), followed by the 5C psychological antecedent (adjusted R2 = 0.36), the theory of planned behavior (adjusted R2 = 0.26), and the health belief model (adjusted R2 = 0.20).ConclusionCOVID-19 vaccine hesitancy in Ethiopia is most predicted by vaccine conspiracy belief. Therefore, public health intervention should focus on addressing misinformation and conspiracy narratives.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12889-025-24470-w.

Background Breast cancer screening is essential for early detection and reducing mortality; however, hesitancy towards screening persists globally, particularly in low- and middle-income countries (LMICs). To further understand the psychological, cultural, and structural barriers we need to utilize the validated tools to measure screening hesitancy as the first step in improving participation rates in the future. Method This systematic scoping review uses the Arksey and O’Malley framework together with the PRISMA extension, to filter studies based on relevancy regarding breast cancer screening and analytical quality. Studies are pulled from academic databases such as PubMed, Scopus, Web of Science, and Google Scholar that include frameworks such as the Health Belief Model (HBM) and Knowledge Attitude Practice (KAP) that focus on psychological and behavioral factors. The studies are pulled from the past decade. Results This review identified numerous frameworks used around the globe for determining screening hesitancy. However, among the most developed countries, HBM and KAP were the most widely used frameworks. These tools have good measurements of psychometric factors, but their lack of cultural adaptation limits their application in more diverse environments, especially in LMICs. Conclusion The findings highlight there need to have a more culturally adaptive, and a high psychometric standard tool for measuring breast cancer screening hesitancy. In the future, research should focus on developing more adaptive tools and using digital platforms to increase accessibility. By addressing these gaps, public health strategies can better reduce screening hesitancy, enhance early detection, and improve health conditions worldwide. BJMS, Vol. 24 No. 04 October’25 Page : 1304-1328

Development and validation of a health belief model scale for oral health behaviors among adolescents.

ABSTRACTBackgroundThe proportion of healthcare workers (HCWs) who receive and recommend seasonal influenza vaccination to their patients remains low in China. This study aims to understand why HCWs infrequently use and recommend the influenza vaccine and how to improve utilization.MethodsA cross‐sectional questionnaire survey and a focus group interview were conducted among primary HCWs in Hubei Province in September 2018 and May 2019. We analyzed qualitative data using descriptive methods and a general inductive approach following a quantitative analysis. In addition, we used the Health Belief Model (HBM) framework to summarize predictors of HCW vaccination and recommendation.ResultsPrimary HCWs acquired basic knowledge about influenza infection and vaccination and were less likely to receive and recommend influenza vaccination. However, from the focus group, HCWs reported influenza was a mild disease and would not recommend vaccination for patients who looked healthy. HCWs raised concerns about adverse events, cost‐effectiveness, and contraindications to influenza vaccination. HCWs reported, “I would be more likely to recommend vaccination if my employer required that I do so.”ConclusionsHealth education materials for HCWs could be improved by providing scientific evidence on the burden of influenza disease, the benefits of vaccination, and national and international policies on influenza vaccination. In addition, interventions that may improve influenza vaccination coverage include workplace requirements for influenza vaccination of HCWs and requirements for HCWs to recommend influenza vaccination to high‐risk groups in addition to providing no‐cost and on‐site vaccination.

Factors Affecting Decisions for Surrogacy Among Nigerian Women After Failed IVF Cycles Using the Health Belief Model

Insights from women and healthcare professionals about preventing pregnancy-related pelvic girdle pain: A qualitative content analysis.

Background: Non-adherence to guideline-directed best medical therapies is prevalent in people with lower extremity peripheral arterial disease (PAD), constituting a significant challenge to effective treatment. Underlying drivers for non-adherence remain poorly understood. This study explored patients' health-related beliefs and behaviours regarding antithrombotic and lipid-lowering therapy to identify opportunities for improvement. Patients and methods: Using a qualitative design, we conducted semi-structured interviews with patients with symptomatic PAD based on a purposeful sampling strategy. Patients were recruited from four vascular surgery departments in Denmark between December 2022 and January 2024, excluding those with cognitive impairment or terminal illness. Data were analysed using framework analysis based on the six domains of the Health Belief Model (HBM): perceived susceptibility, severity, benefits, barriers, cues to action, and self-efficacy. Results: Sixteen patients participated (median age: 69 years, 38% women); 68.8% had intermittent claudication, 18.8% had chronic limb-threatening ischemia, and 12.5% had undergone major amputation. Seven patients were adherent, and nine were non-adherent to secondary preventive therapy. Patients expressed low perceived awareness of PAD severity and its cardiovascular implications. Their perception of PAD centred around leg pain and its impact on everyday life, limiting their understanding of the benefits of secondary preventive therapies. Patients lacked knowledge about treatment goals and did not link secondary preventive therapy with PAD. Adherence barriers included inadequate understanding of PAD's chronic progressive nature, concerns about side-effects, prescription confusion, and financial constraints. Internal adherence triggers included fear of recurring pain, complications, and early death. External cues to action included a trusting patient-provider relationship and receiving comprehensive, understandable information. Conclusions: This study highlights the multifaceted challenges hindering adherence to antithrombotic and lipid-lowering therapies. Addressing the limited disease awareness and the expressed need for patient-centred communication delivered in a trusting patient-provider relationship could serve as starting point for future strategies to improve adherence.

The implementation of integrative medicine in an oncology setting (Integrative Oncology, IO) is increasingly taking place in cancer centers across Israel and worldwide, often together with palliative care. To learn about a collaborative treatment setting involving a team of gyneco-oncology, supportive and palliative care and IO healthcare professionals and practitioners. This narrative-based study analyzed the treatment of a patient with advanced ovarian cancer from the perspectives of healthcare professionals and practitioners from the three disciplines. The patient, a young woman from Israel with a diagnosis of ovarian cancer, had always had a strong affinity toward alternative medicine practices. The medical team at the study center accompanied her from the initial diagnosis until her passing. The narratives presented include those from the IO team of practitioners working in the gyneco-oncology department, her gyneco-oncologist and the palliative care nurse. These perspectives addressed the goals of the IO program, and the quality of the interaction in meeting therapeutic challenges, including during end-of-life care. Clinical collaboration between oncology surgeons, palliative care professionals and IO practitioners may facilitate communication with patients whose health-belief model challenges that of medical and nursing staff. This interaction may create a synergistic process, sharing treatment goals with the patient.

Pathological vaginal discharge is caused by infections from pathogens such as Trichomonas vaginalis, Candida species, Chlamydia trachomatis, and Neisseria gonorrhoeae. Pathological vaginal discharge can cause discomfort, and if left untreated for a long time, it may lead to pelvic inflammatory disease, infertility, and cervical cancer. The Health Belief Model (HBM) is the most commonly used model to guide individuals toward engaging in preventive health behaviors. The application of HBM in preventing pathological vaginal discharge is important because it helps increase awareness and promote preventive behaviors. The use of natural ingredients to address pathological vaginal discharge is becoming more familiar among the community compared to synthetic products due to their safety and affordability.Research Objectives: To analyze the effectiveness of basil leaf decoction, evaluate the influence of HBM on preventing pathological vaginal discharge, and determine the effectiveness of the combination of basil leaf decoction and HBM.Methods: This study employed a quasi-experimental design with a pre-test and post-test control group conducted in Lubuk Pakam village. Respondents were divided into three groups with a total sample size of 150 individuals.Results: Pre-test results showed that initial scores were almost the same across all groups, indicating no significant differences before the intervention. After six weeks, the basil decoction group showed a 24.6% improvement in preventive behavior, the HBM group showed a 33.4% increase, and the combination group showed a 45.7% increase. These findings indicate that the combination of basil leaf decoction and HBM education is more effective than single interventions.The HBM model proved effective in enhancing awareness and preventive behavior, especially when combined with biological intervention such as basil leaf decoction. This combination produced a synergistic effect that encouraged higher compliance and stronger behavioral change compared to single interventions.The combination of basil leaf decoction and education based on the Health Belief Model (HBM) was found to be the most effective in improving preventive behaviors against pathological vaginal discharge in women of reproductive age compared to single interventions. This intervention significantly increased knowledge, perception, and motivation to carry out preventive actions. Therefore, this combined biological and educational approach is recommended for widespread implementation in women's reproductive health programs.

Factors related to the intention to perform a fecal occult blood test for colorectal cancer screening, based on the Health Belief Model and health literacy: A cross-sectional study.

School-based vaccination programs in the United States are a vital component of public health strategy, offering a practical and equitable means of reaching diverse child and adolescent populations. As key sites for immunization delivery, schools have historically contributed to the success of vaccine initiatives while also reflecting the social, cultural, and logistical complexities that shape public health outcomes. This literature review synthesizes research on vaccination programs implemented in the K-12 educational system, with a focus on ethical considerations, cost-efficiency, community engagement, and operational challenges. Grounded in the Health Belief Model, this integrative review explores how risk perceptions, communication strategies, and healthcare provider capacity influence vaccine acceptance and uptake. It further examines how individual decision-making and structural barriers-such as regional policy variation, consent procedures, and school nurse availability-affect program success.

Malaria transmission occurs in tropical countries. Malaria cases continue to be a widespread global health issue in nearly all parts of the world. Malaria prevention can be achieved by changing public perceptions about the dangers of malaria infection through behavioral approaches, one of which is the Health Belief Model (HBM). The purpose of this study is to analyze factors associated with malaria prevention actions based on the Health Belief Model in the working area of the Pagurawan Health Center, Medang Deras District, Batubara Regency, in 2025. This research is descriptive-analytic with a cross-sectional study design. The study was conducted in the working area of the Pagurawan Health Center, Medang Deras District, Batubara Regency, from July 2024 to February 2025. The sample size was 100 respondents, selected through proportional sampling. The results of the study revealed significant relationships with perceived susceptibility (p value 0.000), perceived severity (p value 0.023), perceived benefits (p value 0.002), perceived barriers (p value 0.000), and cues to action (p value 0.000). The most dominant variable was cues to action with an Exp(B) of 14.285.

ABSTRACTIntroductionCervical cancer remains the fourth leading cause of cancer-related deaths among women globally. Female sex workers (FSWs) bear a disproportionately higher burden due to multiple risk factors, yet their uptake of screening remains unknown in Tanzania. Guided by the health belief model (HBM), this study assessed cervical cancer screening uptake and its behavioural determinants among FSWs in Kilimanjaro region.MethodsA community-based cross-sectional study targeting 355 FSWs aged 25–49 years was conducted from May to July 2024 using the respondent-driven sampling technique. Data were collected using a structured interviewer-administered questionnaire with Cronbach’s alpha: 0.75–0.92 and analysed in IBM SPSS V.27.0. The primary outcome was the uptake of lifetime cervical cancer screening. χ2 tests and binary logistic regression were performed to determine the association between HBM constructs and screening uptake; p values <0.05 in the multivariate analysis were considered statistically significant.ResultsOf the 355 FSWs targeted, 351 (98.9%) participated. The participants’ mean age was 36.11±5.24 years; with most residing in urban areas, 232 (66.1%), and 184 (52.3%) completed primary education. Screening uptake was critically low as only 17 (4.8%) (95% CI 2.6 - 7.0) had ever been screened. It was marginally higher among FSWs with a college education (11.1%) and those initiating sex work at ≥25 years (19.9%). Four behavioural factors were significantly associated with screening uptake: perceived severity (AOR)=3.25; 95% CI 1.16-9.07), perceived benefits (AOR=3.61; 95% CI 1.10 -11.84), self-efficacy (AOR=3.59; 95% CI 1.18-10.96) and cues to action (AOR=3.61; 95% CI 1.28- 10.15).ConclusionCervical cancer screening among FSWs in Kilimanjaro was critically low (4.8%). We strongly recommend designing HBM-tailored interventions that target the key behavioural determinants: perceived severity, perceived benefits, self-efficacy and cues to action, to improve the screening rate in this population. However, further study using a qualitative approach is necessary to explore the context-specific barriers.