2.4 -

Health Belief Model
of Health

The School of Health Sciences, Ngee Ann Polytechnic, Singapore

Part 1 The Health Belief Model and Children

In Chapter One we've learnt that there are many reasons why patients may be forced by their psychosocial environment to be non-compliant. The Health Belief Model has been widely used to explain health-related behaviors and as a guiding framework for promoting prevention-based behaviors.

The likelihood of engaging in healthy behaviors is a combination of reasons (e.g., one’s desire to avoid illness) and expectation that engaging in the behavior will promote well-being . Expectations are based on people’s estimates of two separate factors: susceptibility (i.e., the likelihood of contracting a problem condition) and severity (i.e., relative seriousness of the consequences of contracting the problem condition). These perceptions then inform people’s actions, which are determined by their assessment of perceived benefits and barriers. Decisions to engage in healthy behaviors are based on whether the barriers (e.g., costs) are less than the benefits. Engaging in healthy behaviors is thought to be triggered by cues, internal (e.g., bodily pain) or external (e.g., media advertisements), that instigate action.

Let's use the Health Belief Model to understand why behaviour change in children is a shared responsibility among parents, care givers, the home environment and school.

Chapter2HBM.mp4

Food Revolution

Reducing the prevalence of childhood obesity is a global public health focus. Children are 10 times more at risk for obesity when both their parents are obese, and experts in childhood obesity recommend prevention and treatment of obesity in the primary school years should focus on parents, since this is when life habits are formed. Facilitating sustainable behavior change in children via public health interventions is challenging however there are programmes that can influence both child and parent.

The Jamie Oliver Food Foundation works with kids, communities, businesses and policy partners to make food education a priority. The foundation is leading a full-scale Food Revolution to improve the health and happiness of families around the world. The Food Foundation is currently continuing its mission to end childhood obesity. They're committed to raising awareness of and reducing sugar consumption in the UK by advocating for clearer food labeling, a tax on sugary drinks and fairer marketing so kids are not overwhelmed with advertisements for unhealthy, sugar loaded foods.

This video is hosted on Ted within this link:
https://www.ted.com/talks/jamie_oliver_food_revolutionaries#t-339347

Part 2 The Components of the Health Belief Model applied to young children

Obesity in children requires an understanding of causative factors for the individual as well as an understanding of influential factors within the family. A parents’ ability to positively influence a child can be affected by their perception of obesity and its importance. This model accounts for the need to not only recognize obesity but also understand its links to health risks now and in the future. These factors can be due to parental influences on diet, exercise, habit formation, and even attitude and beliefs. These are part of the socialization effect that can occur. Socialization is crucial for preschool children where parents are major influencers on development and lifestyle.

Modifying Variables - What influence us?

(Ukrich, n.d.)

Individual characteristics, including demographic, psychosocial, and structural variables, can affect perceptions (i.e., perceived seriousness, susceptibility, benefits, and barriers) of health-related behaviors. Demographic variables include age, sex, race, ethnicity, and education, among others. Psychosocial variables include personality, social class, and peer and reference group pressure, among others. Structural variables include knowledge about a given disease and prior contact with the disease, among other factors. The health belief model suggests that modifying variables affect health-related behaviors indirectly by affecting perceived seriousness, susceptibility, benefits, and barriers.

Self-Efficacy - What we feel we can do?

Self-efficacy has been shown to be a causal mechanism in behavior change that could also prove to be important in prevention efforts. High parental self-efficacy has been shown to be an important factor in affecting healthy child behaviors, such as improved sleep and less television time, healthy diet and adequate physical activity. Prevention efforts have been deemed a more realistic and cost-effective approach to managing childhood obesity. Parental self-efficacy is important in fostering a supportive home environment that aligns with healthy child growth.

Cues to Action - What are the triggers to make us act?

Cues to action are events that act as a trigger mechanism for engaging in health-related behavior. Cues to action are thought to influence perceived threat as determined by the interaction of susceptibility and severity of risk. Parents and teachers identified child-to-parent communication cues in particular, as the ‘‘most pervasive and effective cues’’ to parent engagement.

Perceived Severity - How serious do we think our illness is?

Parental knowledge of obesity health risks correlates to perceived severity. There is a strong relationship between parental perception of severity of child risk and engagement in prevention programs. How parents perceive the child’s risk of developing an illness is important to behavioral change. One drawback though is some parents misclassify child weight as they do not understand the harm of excess weight in childhood and are not always aware of what comprises a healthy diet and adequate exercise.

Perceived Susceptibility - How much do we think we are at risk?

Parents who believed their children to be susceptible to obesity were more likely to take action.

Perceived Benefits - How much do we think we will be helped by health advice?

Parents are more likely to participate in prevention programs when they can clearly identify the benefits to themselves, their children, and their families, but less likely if these benefits are not as clear.

Perceived Barriers - How much would the actions needed negatively affect me?

Barriers such as lack of time, child care, or transportation, as well as scheduling conflicts are frequently noted. Parents say that barriers affect their ability to stick to any diet/exercise programme for their children.