Page 137 - Nutrition Counseling and Education Skills: A Guide for Professionals

physiologic consequences, and the like.
Clients need feedback about the change to enhance motivation. It can be provided in many ways, such as

self-monitoring records; results of improved medical laboratory tests; positive comments from friends, family,
and the counselor; and the client’s own positive self-talk (“I’m doing better”).

Health Belief Model

One of the first public health theories to try to influence health behaviors was the Health Belief Model
(HBM) that was designed to understand people’s use of preventive health services.22–24 The theory assumes
that health behaviors are motivated in relation to a degree of fear or perceived threat of illness. The HBM uses
four constructs to explain people’s readiness to act: perceived susceptibility; perceived severity; perceived
benefits; and perceived barriers.

If a person imagines being susceptible and it would be a serious illness, such as cancer or stroke, one may be
more likely to reduce the threat of illness by making changes in health behaviors. These concepts might
account for a person’s “readiness to act” and make changes.23–25

Perceived susceptibility may be defined as a person’s opinion of how at risk or vulnerable he or she is to
getting an illness or an adverse medical condition.

Perceived severity is the opinion of how serious the adverse condition is. The threat may be influenced by
other factors, such as knowledge, education, age, socioeconomic status, and cultural group.1

Perceived benefits are the opinions of whether or not a behavior change, as a preventive action, is needed to
reduce the risk or threat of disease and that positive results may be expected. Perceived barriers are the
opinions of the personal costs, time, challenges, or problems of taking action to change a behavior.1,23,24

Later, additions were made to the HBM to better explain behavior. Environmental cues to action, such as
giving the person how-to information or media reports, could direct motivation promoting readiness to act
and make changes. Self-efficacy, one’s belief that one is capable of taking a necessary action or making a change
that will lead to an outcome one desires was recognized to fit the more complex behavior challenges.23 The
HBM suggests that people will engage in healthy behaviors if they value the outcomes. Ways to enhance a
person’s self-efficacy are discussed in Chapter 8.

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