TERM PAPER ON

HEALTH BELIEF AND PRACTICE

BY

NWOKE OLUCHI MARGRET

SUBMITTED TO THE DEPARTMENT OF NURSING SCIENCE

FACULTY OF HEALTH SCIENCE IMO STATE
UNIVERSITY, OWERRI

IN PARTIAL FULFILLMENT OF WELLNESS AND HEALTH

PROMOTION NSC 701

LECTURER

DR. VINCENT CHINELO

JUNE 2023

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 TABLE OF CONTENT

Introduction 1

Concept of Health 3
Determinants of Health 5
Factors Affecting Health Belief 6
Health Practices 7
The Health Belief Model 9

Introduction
Religion, culture, beliefs, and ethnic customs can influence how patients
understand health concepts, how they take care of their health, and how they make
decisions related to their health. Without proper training, clinicians may deliver
medical advice without understanding how health beliefs and cultural practices
influence the way that advice is received. Asking about patients' religions, cultures,
and ethnic customs can help clinicians engage patients so that, together, they can
devise treatment plans that are consistent with the patients' values( Bornstein, 2017).
According to Christoff, and Eckersley, (2013) Health beliefs, particularly
feelings of self-efficacy, relate to an individual's perceived ability to perform a

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certain behavior. These perceptions of self-efficacy may influence whether
individuals will attempt certain behaviors and how the behaviors will be carried
out.
Many factors combine together to affect the health of individuals and
communities. Whether people are healthy or not, is determined by their
circumstances and environment. To a large extent, factors such as where we live,
the state of our environment, genetics, our income and education level, and our
relationships with friends and family all have considerable impacts on health,
whereas the more commonly considered factors such as access and use of health
care services often have less of an impact (Clifford, 2016).

Aim and Objectives

The aim of this seminar paper is to review health belief and practices. The specific

objectives include:-

1. Concept of Health
2. Determinants of Health
3. Factors Affecting Health Belief
4. Health Practices
5. The Health Belief Model

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Definition of terms
Health. Health is a state of complete physical, mental and social wellbeing of an

individual and not merely the absence of disease or infirmity

Belief. An acceptance that something exists or is true

Practice the actual application or use an idea belief or methods asopposed to

theories relating to it

Concept of Health
The word “Health” can be used in a number of ways. Definitions of health
differ from individual to individuals, community to community, and from
environment to environment. Some people feel that health is when one is not ill.
Others take health to mean total absence of disease; while some people still liken it
to reduced mortality rate. Health is a state of complete physical, mental and social
wellbeing of an individual and not merely the absence of disease or infirmity.
Health is a state of being well, sound or whole in mind, body and soul; especially
the state of being free from physical disease or trauma. Edungbola, (2013)

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described health as an effective living of every individual which involves
maintaining a certain level of the body functions, through active living; which
means that health is the quality of life that result from the total functioning of the
individual that empower him/her to obtain personal satisfying and socially useful
life.
According to Khayat, (2017) health is a dynamic wellbeing of an individual
characterized by a physical and mental potential, which satisfies the demands of
life commensurate with age, culture and personal responsibility. Health is partly a
reflection of individual’s biological status, a matter of how well the body
component/parts are working, a consequence of individual and collective behavior,
a reflection of individual’s ability to maintain stable emotional status and to co-
exist with other people (Peters, 2017).

Determinants of Health
Ryan, (2011) the determinants of health include:

 the social and economic environment,

 the physical environment, and
 the person’s individual characteristics and behaviours.
The context of people’s lives determine their health, and so blaming individuals for
having poor health or crediting them for good health is inappropriate. Individuals
are unlikely to be able to directly control many of the determinants of health. These
determinants—or things that make people healthy or not—include the above
factors, and many others:
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  Income and social status - higher income and social status are linked to
better health. The greater the gap between the richest and poorest people, the
greater the differences in health.
 Education – low education levels are linked with poor health, more stress
and lower self-confidence.
 Physical environment – safe water and clean air, healthy workplaces, safe
houses, communities and roads all contribute to good health. Employment
and working conditions – people in employment are healthier, particularly
those who have more control over their working conditions
 Social support networks – greater support from families, friends and
communities is linked to better health. Culture - customs and traditions, and
the beliefs of the family and community all affect health.
 Genetics - inheritance plays a part in determining lifespan, healthiness and
the likelihood of developing certain illnesses. Personal behaviour and coping
skills – balanced eating, keeping active, smoking, drinking, and how we deal
with life’s stresses and challenges all affect health.
 Health services - access and use of services that prevent and treat disease
influences health
 Gender - Men and women suffer from different types of diseases at different
ages.

Factors Affecting Health Belief

 Health beliefs: In some cultures, people believe that talking about a possible
poor health outcome will cause that outcome to occur.
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  Health customs: In some cultures, family members play a large role in
health care decision making.
 Ethnic customs: Differing roles of women and men in society may
determine who makes decisions about accepting and following through with
medical treatments.
 Religious beliefs: Religious faith and spiritual beliefs may affect health
care-seeking behavior and people's willingness to accept specific treatments
or behavior changes.
 Dietary customs: Disease-related dietary advice will be difficult to follow if
it does not conform to the foods or cooking methods used by the patient.
 Interpersonal customs: Eye contact or physical touch will be expected in
some cultures and inappropriate or offensive in others.

Health Practices
Davis and Stoppler (2018) noted that health practices include:
Healthy eating. The most important step for a person to have a healthy lifestyle is
by taking care of his or her food intake. According to Davis and Stoppler (2018), a
person must eat three meals a day which are breakfast, lunch, and dinner, and he or
she must control the size of the meal every time he or she wants to eat.
Exercise regularly. Another major contributor to a healthy lifestyle is to do
physical activity or exercise (Davis &Stoppler, 2018). Exercises such as
swimming, yoga, pilates, jogging, aerobics and others are good for the body and
mind. People who are not used to exercise should remember to stretch all of their

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body parts before they do intense physical activities so they will not get hurt during
the activity. It is also advisable to have breakfast before exercising so that their
body has ample energy to work out. It is suggested that a person can start exercise
from 30 to 60 minutes for 3 times a week to live healthily (Davis &Stoppler,
2018).
Get enough sleep. Getting enough sleep is very important to all age and for
example, most adults need 7 to 8 hours of deep sleep in order to function optimally
and to maintain a healthy lifestyle. In addition to that, getting enough sleep has
been strongly linked to proper immune system functioning and also cardiovascular
health. As stated by Sparacino (2018), getting enough sleep is an important part of
living a healthy lifestyle as it can help to ease their physical body and mental
conditions. When a person gets enough sleep, it can strengthen and improves his or
her memory and enables him or her to handle stress and pressure better.
Avoid stress. According to Reese (2016), stress is part of life and it is unavoidable.
As people grow older, they tend to experience new types of stress as they will have
more responsibility such as their job or they have family members to look after.
However, it does not mean that they should ignore the stress. When people do not
deal with their stress properly, it can lead them to have serious physical and mental
health problems.
Stop smoking. People should quit smoking because a smoke-free lifestyle will
help to improve their health. When a person quit smoking, it can decrease the risk
of getting lung cancer, heart disease, stroke, and respiratory diseases. Besides, by
quitting from smoking he or she can help others such as their unborn baby,
children and other family members from being passive smokers.
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Avoid alcohol. Another step to live a healthy lifestyle is by not consuming alcohol
because it can lead a person to get diseases like stroke, high blood pressure,
cancers and organ failures (Ducharme, 2018). Furthermore, instead of being a
sober, they can enjoy their daily life and able to remember what they had done
before.
The Health Belief Model
The health belief model (HBM) is a psychological health behavior change model
developed to explain and predict health-related behaviors, particularly in regard to
the uptake of health services. The health belief model was developed in the 1950s
by social psychologists at the U.S. Public Health Service and remains one of the
best known and most widely used theories in health behavior research.
The health belief model suggests that people’s beliefs about health problems,
perceived benefits of action and barriers to action, and self-efficacy explain
engagement (or lack of engagement) in health-promoting behavior. A stimulus, or
cue to action, must also be present in order to trigger the health-promoting
behavior.
Four Components of Health Belief Model
Perceived Severity
Perceived severity refers to the subjective assessment of the severity of a health
problem and its potential consequences. The health belief model proposes that
individuals who perceive a given health problem as serious are more likely to
engage in behaviors to prevent the health problem from occurring (or reduce its
severity). Perceived seriousness encompasses beliefs about the disease itself (e.g.,
whether it is life-threatening or may cause disability or pain) as well as broader
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impacts of the disease on functioning in work and social roles. For instance, an
individual may perceive that influenza is not medically serious, but if he or she
perceives that there would be serious financial consequences as a result of being
absent from work for several days, then he or she may perceive influenza to be a
particularly serious condition.
Perceived Susceptibility
Perceived susceptibility refers to subjective assessment of risk of developing a
health problem. The health belief model predicts that individuals who perceive that
they are susceptible to a particular health problem will engage in behaviors to
reduce their risk of developing the health problem. Individuals with low perceived
susceptibility may deny that they are at risk for contracting a particular illness.
Others may acknowledge the possibility that they could develop the illness, but
believe it is unlikely. Individuals who believe they are at low risk of developing an
illness are more likely to engage in unhealthy, or risky, behaviors. Individuals who
perceive a high risk that they will be personally affected by a particular health
problem are more likely to engage in behaviors to decrease their risk of developing
the condition.
The combination of perceived severity and perceived susceptibility is referred to as
perceived threat. Perceived severity and perceived susceptibility to a given health
condition depend on knowledge about the condition. The health belief model
predicts that higher perceived threat leads to higher likelihood of engagement in
health-promoting behaviors.

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Perceived Benefits
Health-related behaviors are also influenced by the perceived benefits of taking
action. Perceived benefits refer to an individual’s assessment of the value or
efficacy of engaging in a health-promoting behavior to decrease risk of disease. If
an individual believes that a particular action will reduce susceptibility to a health
problem or decrease its seriousness, then he or she is likely to engage in that
behavior regardless of objective facts regarding the effectiveness of the action. For
example, individuals who believe that wearing sunscreen prevents skin cancer are
more likely to wear sunscreen than individuals who believe that wearing sunscreen
will not prevent the occurrence of skin cancer.
Perceived Barriers
Health-related behaviors are also a function of perceived barriers to taking action.
Perceived barriers refer to an individual’s assessment of the obstacles to behavior
change. Even if an individual perceives a health condition as threatening and
believes that a particular action will effectively reduce the threat, barriers may
prevent engagement in the health-promoting behavior. In other words, the
perceived benefits must outweigh the perceived barriers in order for behavior
change to occur. Perceived barriers to taking action include the perceived
inconvenience, expense, danger (e.g., side effects of a medical procedure) and
discomfort (e.g., pain, emotional upset) involved in engaging in the behavior. For
instance, lack of access to affordable health care and the perception that a flu
vaccine shot will cause significant pain may act as barriers to receiving the flu
vaccine.

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Modifying Variables
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.
Cues to Action
The health belief model posits that a cue, or trigger, is necessary for prompting
engagement in health-promoting behaviors. Cues to action can be internal or
external. Physiological cues (e.g., pain, symptoms) are an example of internal cues
to action. External cues include events or information from close others, the media,
or health care providers promoting engagement in health-related behaviors.
Examples of cues to action include a reminder postcard from a dentist, the illness
of a friend or family member, and product health warning labels. The intensity of
cues needed to prompt action varies between individuals by perceived
susceptibility, seriousness, benefits, and barriers. For example, individuals who
believe they are at high risk for a serious illness and who have an established
relationship with a primary care doctor may be easily persuaded to get screened for
the illness after seeing a public service announcement, whereas individuals who

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believe they are at low risk for the same illness and also do not have reliable access
to health care may require more intense external cues in order to get screened.
Self-Efficacy
Self-efficacy was added to the four components of the health belief model (i.e.,
perceived susceptibility, seriousness, benefits, and barriers) in 1988. Self-efficacy
refers to an individual’s perception of his or her competence to successfully
perform a behavior. Self-efficacy was added to the health belief model in an
attempt to better explain individual differences in health behaviors. The model was
originally developed in order to explain engagement in one-time health-related
behaviors such as being screened for cancer or receiving an immunization.
Eventually, the health belief model was applied to more substantial, long-term
behavior change such as diet modification, exercise, and smoking. Developers of
the model recognized that confidence in one’s ability to effect change in outcomes
(i.e., self-efficacy) was a key component of health behavior change.
Empirical Support
The health belief model has gained substantial empirical support since its
development in the 1950s. It remains one of the most widely used and well-tested
models for explaining and predicting health-related behavior. A 1984 review of 18
prospective and 28 retrospective studies suggests that the evidence for each
component of the health belief model is strong. The review reports that empirical
support for the health belief model is particularly notable given the diverse
populations, health conditions, and health-related behaviors examined and the
various study designs and assessment strategies used to evaluate the model. A
more recent meta-analysis found strong support for perceived benefits and
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perceived barriers predicting health-related behaviors, but weak evidence for the
predictive power of perceived seriousness and perceived susceptibility. The
authors of the meta-analysis suggest that examination of potential moderated and
mediated relationships between components of the model is warranted.
Applications
The health belief model has been used to develop effective interventions to change
health-related behaviors by targeting various aspects of the model’s key constructs.
Interventions based on the health belief model may aim to increase perceived
susceptibility to and perceived seriousness of a health condition by providing
education about prevalence and incidence of disease, individualized estimates of
risk, and information about the consequences of disease (e.g., medical, financial,
and social consequences). Interventions may also aim to alter the cost-benefit
analysis of engaging in a health-promoting behavior (i.e., increasing perceived
benefits and decreasing perceived barriers) by providing information about the
efficacy of various behaviors to reduce risk of disease, identifying common
perceived barriers, providing incentives to engage in health-promoting behaviors,
and engaging social support or other resources to encourage health-promoting
behaviors. Furthermore, interventions based on the health belief model may
provide cues to action to remind and encourage individuals to engage in health-
promoting behaviors. Interventions may also aim to boost self-efficacy by
providing training in specific health-promoting behaviors, particularly for complex
lifestyle changes (e.g., changing diet or physical activity, adhering to a complicated
medication regimen). Interventions can be aimed at the individual level (i.e.,
working one-on-one with individuals to increase engagement in health-related
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behaviors) or the societal level (e.g., through legislation, changes to the physical
environment).
Limitations
The health belief model attempts to predict health-related behaviors by accounting
for individual differences in beliefs and attitudes. However, it does not account for
other factors that influence health behaviors. For instance, habitual health-related
behaviors (e.g., smoking, seatbelt buckling) may become relatively independent of
conscious health-related decision making processes. Additionally, individuals
engage in some health-related behaviors for reasons unrelated to health (e.g.,
exercising for aesthetic reasons). Environmental factors outside an individual’s
control may prevent engagement in desired behaviors. For example, an individual
living in a dangerous neighborhood may be unable to go for a jog outdoors due to
safety concerns. Furthermore, the health belief model does not consider the impact
of emotions on health-related behavior. Evidence suggests that fear may be a key
factor in predicting health-related behavior.
The theoretical constructs that constitute the health belief model are broadly
defined. Furthermore, the health belief model does not specify how constructs of
the model interact with one another. Therefore, different operationalizations of the
theoretical constructs may not be strictly comparable across studies.
Research assessing the contribution of cues to action in predicting health-related
behaviors is limited. Cues to action are often difficult to assess, limiting research in
this area. For instance, individuals may not accurately report cues that prompted
behavior change. Cues such as a public service announcement on television or on a
billboard may be fleeting and individuals may not be aware of their significance in
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prompting them to engage in a health-related behavior. Interpersonal influences are
also particularly difficult to measure as cues
Conclusions

Some people feel that health is when one is not ill. Others take health to mean total

absence of disease; while some people still liken it to reduced mortality rate.

Health is a state of complete physical, mental and social wellbeing of an individual

and not merely the absence of disease or infirmity. Health is a state of being well,

sound or whole in mind, body and soul; especially the state of being free from

physical disease or trauma.

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