Evaluating the effectiveness of health belief model interventions in improving adherence: A systematic review

Jones, Christina Jane; Smith, Helen; Llewellyn, Carrie

doi:10.1080/17437199.2013.802623

Cited by 421Behavioral Health and InterventionsMedication Adherence and ComplianceMedia Influence and Health

Evaluating the effectiveness of health belief model interventions in improving adherence: A systematic review

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Jones, Christina Jane, Smith, Helen, Llewellyn, Carrie·2014·Health Psychology Review

DOI 10.1080/17437199.2013.802623

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Abstract

Lack of adherence to health-promoting advice challenges the successful prevention and management of many conditions. The Health Belief Model (HBM) was developed in 1966 to predict health-promoting behaviour and has been used in patients with wide variety of disease. The HBM has also been used to inform the development of interventions to improve health behaviours. Several reviews have documented the HBM's performance in predicting behaviour, but no review has addressed its utility in the design of interventions or the efficacy of these interventions. A systematic review was conducted to identify interventional studies which use the HBM as the theoretical basis for intervention design. The HBM has been used continuously in the development of behaviour change interventions for 40 years. Of 18 eligible studies, 14 (78%) reported significant improvements in adherence, with 7 (39%) showing moderate to large effects. However, only six studies used the HBM in its entirety and five different studies measured health beliefs as outcomes. Intervention success appeared to be unrelated to HBM construct addressed challenging the utility of this model as the theoretical basis for adherence-enhancing interventions. Interventions need to be described in full to allow for the identification of effective components and replication of studies.

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Individuals are more inclined to adopt healthy behaviors when confronted with a substantial threat and when their actions are perceived as effectively reducing the likelihood or severity of that threat.
“It has been suggested that individuals are more inclined to adopt healthy behaviors when confronted with a substantial threat and when their actions are perceived as effectively reducing the likelihood or severity of that threat [43].”
From Patient-Perceived Factors Influencing Physical Activity Sensor Use in Stroke Prevention and Rehabilitation: Systematic Review of Qualitative Studies Using Thematic Synthesis (2026) · cites this paper as [43]
BCTTv1 has been used by systematic reviewers to identify BCTs within intervention papers, in order to facilitate intervention comparison and evaluate technique efficacy.
“BCTTv1 has also been used by systematic reviewers to identify BCTs within intervention papers, in order to facilitate intervention comparison and evaluate technique efficacy (e.g. [42–47]).”
From From Theory-Inspired to Theory-Based Interventions: A Protocol for Developing and Testing a Methodology for Linking Behaviour Change Techniques to Theoretical Mechanisms of Action (2018) · cites this paper as [42]

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Authors: Jones, C. J., Smith, H., & Llewellyn, C.
Affiliations: Brighton and Sussex Medical School (GB)
Corresponding author: Jones, Christina Jane
ORCID: Jones, Christina Jane
Smith, Helen
Llewellyn, Carrie
Venue: Health Psychology Review
Publisher: Informa UK Limited
Published: 2013-06-12
Volume: 8
Issue: 3
Pages: 253-269
ISSN: 1743-7199 (ISSN-L)
1743-7202
DOI: 10.1080/17437199.2013.802623
OpenAlex: W2069208833
Cited by: 421
References: 57
Citations by year: 2026: 30 · 2025: 42 · 2024: 45 · 2023: 39 · 2022: 48 · 2021: 43 · 2020: 92 · 2019: 21 · 2018: 14 · 2017: 20 · 2016: 12 · 2015: 12 · 2014: 2 · 2013: 1
FWCI: 1.10
Type: journal article
Language: en
Open access: green
figshare.com
Licence: cc-by
Locations: Health Psychology Review (publishedVersion)
PubMed (publishedVersion)
Sussex Research Online (University of Sussex) (submittedVersion)
Figshare (submittedVersion, cc-by)
Topics: Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
Social Sciences › Arts and Humanities › Literature and Literary Theory › Media Influence and Health
Keywords: Health Belief Model, medication adherence, behaviour change interventions, intervention effectiveness, health beliefs, health behavior
MeSH terms: Humans, Health Knowledge, Attitudes, Practice, Models, Psychological, Patient Compliance, Health Behavior

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Evaluating the effectiveness of health belief model interventions in improving adherence: A systematic review

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