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A Meta-Analysis of the Effectiveness of Health Belief Model Variables in Predicting Behavior
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Abstract
The Health Belief Model (HBM; Rosenstock, 1966) was constructed to explain which beliefs should be targeted in communication campaigns to cause positive health behaviors. The model specifies that if individuals perceive a negative health outcome to be severe, perceive themselves to be susceptible to it, perceive the benefits to behaviors that reduce the likelihood of that outcome to be high, and perceive the barriers to adopting those behaviors to be low, then the behavior is likely for those individuals. A meta-analysis of 18 studies (2,702 subjects) was conducted to determine whether measures of these beliefs could longitudinally predict behavior. Benefits and barriers were consistently the strongest predictors. The length of time between measurement of the HBM beliefs and behavior, prevention versus treatment behaviors, and drug-taking regimens versus other behaviors were identified as moderators of the HBM variables' predictive power. Based on the weakness of two of the predictors, the continued use of the direct effects version of the HBM is not recommended.
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“Research has shown that the HBM constructs are predictive of actual behavior”
From Treatment histories, barriers, and preferences for individuals with symptoms of generalized anxiety disorder (2024) · cites this paper as Carpenter, 2010
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Sun behavior: exploring the health belief model on skin cancer prevention in Spain
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Enhancing Employee Assistance Programs for Stress Management in Thailand: Employees’ Perspectives
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“It has been demonstrated across numerous domains that the HBM can explain and predict various health-related behaviors (Carpenter, 2010; Janz & Becker, 1984).”
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“These findings support the HBM assumption that nonfamilial interaction with diabetic patients would lead to development of college students’ perceptions of vulnerability to diabetes (Cao, Chen, &Wang, 2014; Conner & Norman, 2005; Davis, Campbell, Hildon, Hobbs, & Michie, 2014; Rosenstock, 1974).”
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The personal, local and global influences on youth sexual behaviors in a traditional society
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“…use of tanning beds, increasing vaccination reception, increasing screening blood tests, and more importantly to the current study, engaging in risk mitigation strategies in response to the H1N1 virus (Carpenter, 2010; Greene & Brinn, 2003; Steers et al., 1996; Taha et al., 2013; Yoo et al., 2013).”
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“Even if evidence points to perceived benefits and barriers being the strongest predictor of behavior change [19, 32], cues to actions are essential, as seen in our results.”
ResultInfluence of Text and Participant Characteristics on Perceived and Actual Text Difficulty
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“Perceived benefits exactly comply with this argument as it positively impacts the intentions toward safety behavior (Carpenter, 2010).”
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TELL ME Design: Protective Behaviour During an Epidemic
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InfluentialAgrawal, L., DaSouza, R. O., Mulgund, P., & Chaudhary, P. (2025) · JMIR Cancer · doi:10.2196/67650 · Cited by 5
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Perspectives on Airway Protection: A Mixed Methods Investigation in People With Parkinson's Disease
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“Furthermore, this discovery provides new empirical support for the health belief model, emphasizing that individuals ’ perceptions of health threats and beliefs about treatment ef fi cacy are critical factors in fl uencing health behaviors (73).”
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Huang, J., Jing, C., & Zhao, X. (2022) · International Journal of Contemporary Hospitality Management · doi:10.1108/ijchm-12-2021-1553 · Cited by 5
Experience and Behaviour(s) of Students who use Nyaope Drug at a South African University
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“Individuals ’ perceptions of symptoms (e.g., chest pains, wheezing, etc.) are examples of internal cues to action (25).”
InfluentialBad Feminists? Perceived Self-Discrepancy Predicts Differences in Gender Equality Activism
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“developed and measured element of the model compared to other major HBM constructs (Carpenter, 2010; Champion & Skinner, 2008; C. L. Jones et al., 2015).”
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“…and samples suggests that the Theory of Planned Behaviour is a more useful model than the Health Belief Model in predicting health behaviours (Carpenter, 2010; Conner & Norman, 2015), there has been no research directly comparing their predictive validity for men’s help-seeking for cancer…”
Development of health belief in emerging infectious respiratory disease preventive behaviors' scale
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An Integrated Health Belief Model: Predicting Uptake of the First COVID-19 Booster Vaccine
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“More recently, Jones et al. (2015) addressed the HBM research design problems identified by Carpenter (2010) by showing the advantages of going beyond the direct parallel model to consider the interaction of the HBM variables.”
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“This is theoretically supported in both the health belief model [27, 28], for health behavior and the technology acceptance model [16, 17], both of which acknowledge bene fi t/usefulness and burden/ease of use contributing to a person ’ s intention to perform a behavior or use a device.”
Krogsgaard, M., Dreyer, P., & Thomsen, T. (2023) · Colorectal Disease · doi:10.1111/codi.16750 · Cited by 5
“Information may serve as a ‘cue to action’, promote engagement in health-related behaviours and preserve patient autonomy [25, 26, 40].”
BackgroundPrEP on TikTok: benefits, barriers, and possibilities
Schwartz, J., Grimm, J., & Jamison, C. (2023) · Communication Research Reports · doi:10.1080/08824096.2023.2269080 · Cited by 5
“In a meta-analysis of 18 HBM studies involving 2,010 participants, Carpenter (2010) found that benefits and barriers were the consistently strongest predictors of health-related behavior change.”
BackgroundEshun, G., Kyei‐Arthur, F., Abdou, M. S. M., Agyekum, M. W., Sarfo, M., Agbenyeavu, J. K., Addai, S. A., Adjei, J. A., Obeng, N., Turzin, J. K., et al. (2024) · BMC Public Health · doi:10.1186/s12889-024-20201-9 · Cited by 5
“…behaviour is more likely to happen among people who may think there will be little or no obstacles to adopting behaviours, that it will lower the chance of a negative health outcome, that it will have a significant negative impact on their health, and if they think they are vulnerable to it [34].”
BackgroundCosta, E. C. V., Oliveira, R. M. D. S., & Pereira, M. G. (2015) · International Journal of Sexual Health · doi:10.1080/19317611.2015.1080779 · Cited by 5
“…research on HBM shows that perceived benefits, perceived barriers, and self-efficacy are the strongest predictors of health-related behaviors (Carpenter, 2010; Lin, Somini, & Zemon, 2005) and have an impact on the willingness to accept VCT testing (Vermeer, Bos, Mbwambo, Kaaya, & Schaalma,…”
BackgroundTarkang, E. E. (2014) · Journal of Scientific Research and Reports · doi:10.9734/jsrr/2015/11334 · Cited by 5
Does Identification of Previously Undiagnosed Conditions Change Care‐Seeking Behavior?
Myerson, R. M., Colantonio, L. D., Safford, M. M., & Huang, E. S. (2017) · Health Services Research · doi:10.1111/1475-6773.12644 · Cited by 5
“Our analysis builds on previous investigations of the relationship between health beliefs and health care seeking behaviors and provides several methodological advantages with respect to studying Medicare beneficiaries ( Janz and Becker 1984; Carpenter 2010; Edwards 2013).”
MethodExamining preconception care-related knowledge and attitudes among Chinese immigrants in Canada
Teng, J., & Ahmed, R. (2017) · International Journal of Migration Health and Social Care · doi:10.1108/ijmhsc-10-2015-0039 · Cited by 5
Park, Y., Lee, S. H., Yi, Y. M., Lee, C. Y., & Lee, M. H. (2018) · Research in Community and Public Health Nursing · doi:10.12799/jkachn.2018.29.3.322 · Cited by 5
“This is similar to the results of a meta-analysis study of the health belief model [27], in which perceived susceptibility and perceived severity constituting perceived threat were somewhat less influential in explaining health behaviors except medication adherence.”
ResultWong, V. C. W., Yuen, J. W. M., Su, X., & Yung, J. Y. K. (2019) · IntechOpen eBooks · doi:10.5772/intechopen.86503 · Cited by 5
“The practice of using archived records for talking and reminder purpose consistent with the health belief model which emphasizes beholders’ awareness of threat perception (risk) and positive initiatives (opportunity) is the key to trigger appropriate actions for realizing positive health outcomes [26, 27].”
BackgroundCuevas, C. D. L., Betancort, M., & de León, J. (2020) · Human Psychopharmacology Clinical and Experimental · doi:10.1002/hup.2721 · Cited by 5
“…in the 1950s, the health belief model has become the most widely applied psychological health behavior change model used to explain and predict health-related behaviors, such as medication adherence (Carpenter, 2010; Holmes, Hughes, & Morrison, 2014; Kelly, Mamon, & Scott, 1987; Rosenstock, 1974).”
BackgroundPettinico, G., & Debevec, K. (2020) · Health Marketing Quarterly · doi:10.1080/07359683.2020.1713579 · Cited by 5
“Related to shared decision making is the health belief model, which remains one of the most widely used theories in health-behavior research (Carpenter, 2010; Rosenstock, 1974).”
MethodAddressing Underserved Populations and Disparities in Behavior Change
Schüz, B., & Hooper, M. W. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108677318.027 · Cited by 5
Health Information Seeking Behaviour, Risk Communication, and Mobility During COVID-19
Schoenherr, J. R., & Thomson, R. (2020) · IEEE International Symposium on Technology and Society (ISTAS) · doi:10.1109/istas50296.2020.9462203 · Cited by 5
Can, F., Ergül‐Topçu, A., & Topçu, G. (2021) · Social Work in Public Health · doi:10.1080/19371918.2021.1965938 · Cited by 5
“Similarly, in a meta-analysis study, perceived benefits and barriers were the strongest predictors of behavior, while the perceived susceptibility was the weakest (Carpenter, 2010).”
Vaccine Hesitancy and Support for Employer Vaccine Mandates
Ashwell, D., Cullinane, J., & Croucher, S. M. (2021) · Frontiers in Communication · doi:10.3389/fcomm.2021.780415 · Cited by 5
“Research has empirically supported the notion that health campaigns have a positive effect on adoption of behaviors (Hyman et al., 1994; Champion et al., 2005; Carpenter, 2010; Jones et al., 2015; Chen and Liu, 2021; Lachlan et al., 2021).”
BackgroundMethodInfluentialDeng, Y.-M., Wu, H.-W., & Liao, H. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19063744 · Cited by 5
“The HBM-based studies added self-efficacy [17,36] as an additional variable and proved to have better explanatory capability [30].”
BackgroundPromoting users’ smartphone avoidance intention: the role of health beliefs
Hai-ping, Z., Deng, S., Yong, L., Xia, S., Lim, E. T. K., & Tan, C. (2022) · Industrial Management & Data Systems · doi:10.1108/imds-07-2020-0420 · Cited by 5
Lee, G., & Park, S. H. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.1025638 · Cited by 5
“One meta-analysis result showed that perceived severity and susceptibility are relatively weaker predictors of health behaviors engagement than other HBM constructs and they may only have an indirect effect on health behaviors as described in the extended parallel model (Carpenter, 2010).”
BackgroundOng, Y. X., Kim, H. K., Pelzer, B. O., Tan, Y., Lim, W. P., Chua, A. K. L., & Koh, B. Y. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1085208 · Cited by 5
“Theoretical frameworks, such as the Health Belief Model (HBM) (Carpenter, 2010) and the RPA Framework (Rimal and Real, 2003), highlight the important roles of risk perception (i.e., perceived vulnerability and perceived severity) and perceived preventive efficacy in predicting preventive behaviors.”
BackgroundYang, J.-Y., Kim, M., & Sohn, A. (2023) · Healthcare · doi:10.3390/healthcare12010086 · Cited by 5
“This singular relationship with barrier beliefs could be the result of an emphasis on external factors such as policies and education, which diverge from the typical intrinsic motivations associated with health behaviors [42].”
The impact of China’s endowment insurance system on health behavior
Yu, L., & Xia, Z. (2024) · Journal of Chinese Governance · doi:10.1080/23812346.2024.2309597 · Cited by 5
Metadata
- Authors
- Carpenter, C. J.
- Affiliations
- Western Illinois University (US)
- Corresponding author
- Carpenter, Christopher J.
- Venue
- Health Communication
- Publisher
- Informa UK Limited
- Published
- 2010-11-30
- Volume
- 25
- Issue
- 8
- Pages
- 661-669
- ISSN
- 1041-0236 (ISSN-L)
- 1532-7027
- OpenAlex
- W2102635611
- Cited by
- 1,604
- References
- 37
- Citations by year
- 2026: 138 · 2025: 133 · 2024: 118 · 2023: 173 · 2022: 166 · 2021: 190 · 2020: 164 · 2019: 108 · 2018: 75 · 2017: 78 · 2016: 93 · 2015: 53 · 2014: 53 · 2013: 30 · 2012: 24
- FWCI
- 2.04
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Health Communication (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
- Social Sciences › Communication › Media Influence and Health
- Health Sciences › Health Professions › General Health Professions › Health and Wellbeing Research
- Keywords
- Health Belief Model, health behavior prediction, perceived benefits, perceived barriers, perceived susceptibility, perceived severity, health campaigns, longitudinal prediction
- MeSH terms
- Humans, Health Knowledge, Attitudes, Practice, Models, Psychological, Health Behavior, Health Communication
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