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

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

Open access

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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Richmond, J., Fernandez, J. R., Bonnet, K. R., Sellers, A., Schlundt, D. G., Forde, A. T., Wilkins, C. H., & Aldrich, M. C. (2024) · JAMA Network Open · doi:10.1001/jamanetworkopen.2024.12880 · Cited by 28
Changing Behavior by Changing Environments
Marteau, T. M., Fletcher, P. C., Hollands, G. J., & Munafo, M. R. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108677318.014 · Cited by 32
Stay Socially Distant and Wash Your Hands: Using the Health Belief Model to Determine Intent for COVID-19 Preventive Behaviors at the Beginning of the Pandemic
Guidry, J. P. D., O’Donnell, N. H., Austin, L., Coman, I. A., Adams, J., & Perrin, P. B. (2021) · Health Education & Behavior · doi:10.1177/10901981211019920 · Cited by 28
The application of health behavior theories to promote cervical cancer screening uptake
Dsouza, J. P., Van den Broucke, S., Pattanshetty, S., & Dhoore, W. (2021) · Public Health Nursing · doi:10.1111/phn.12944 · Cited by 27
Design, Implementation, and Evaluation of Behavior Change Interventions: A Ten-Task Guide
Abraham, C., & Denford, S. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108677318.019 · Cited by 27
Changing Behavior Using the Reflective-Impulsive Model
Deutsch, R., & Strack, F. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108677318.012 · Cited by 30
The Influence of Parents on Medication Adherence of Their Children in China: A Cross-Sectional Online Investigation Based on Health Belief Model
Ge, P., Liu, S., Xu, S., Zhang, J.-Z., Lai, Y., Fu, R.-C., Ke, X., Zhao, J., Bian, Y., & Wu, Y. (2022) · Frontiers in Public Health · doi:10.3389/fpubh.2022.845032 · Cited by 26
Dyadic Behavior Change Interventions
Scholz, U., Berli, C., Lüscher, J., & Knoll, N. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108677318.043 · Cited by 26
Facing flood disaster: A cluster randomized trial assessing communities’ knowledge, skills and preparedness utilizing a health model intervention
Noor, M. T. M., Shahar, H. K., Baharudin, M. R., Ismail, S. N. S., Manaf, R. A., Said, S. M., Ahmad, J., & Muthiah, S. G. (2022) · PLoS ONE · doi:10.1371/journal.pone.0271258 · Cited by 33
“At the same time, selecting the correct theory during module manufacturing is critical to delivering the appropriate and accurate intervention [34].”
Background
Application of Health Belief Model to Practice of Responsible Gambling
Tong, K. K., Chen, J. H., & Wu, A. M. S. (2019) · Journal of Gambling Studies · doi:10.1007/s10899-019-09871-y · Cited by 24
Developing Behavior Change Interventions
Hankonen, N. E., & Hardeman, W. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108677318.021 · Cited by 28
Differences and similarities of physical activity determinants between older adults who have and have not experienced a fall: Testing an extended health belief model
Kaushal, N., Preissner, C. E., Charles, K., & Knaüper, B. (2020) · Archives of Gerontology and Geriatrics · doi:10.1016/j.archger.2020.104247 · Cited by 23
Comparing motivational, self-regulatory and habitual processes in a computer-tailored physical activity intervention in hospital employees - protocol for the PATHS randomised controlled trial
Kwaśnicka, D., Vandelanotte, C., Rebar, A. L., Gardner, B., Short, C. E., Duncan, M. J., Crook, D., & Hagger, M. S. (2017) · BMC Public Health · doi:10.1186/s12889-017-4415-4 · Cited by 21
“BCTs used in the control group are: providing information about health consequences [49], providing information about social [50], environmental [51] and emotional consequences [52].”
Beyond health beliefs: the role of trust in the HPV vaccine decision-making process among American college students
MacArthur, K. R. (2017) · Health Sociology Review · doi:10.1080/14461242.2017.1381035 · Cited by 23
Self-efficacy Mediates Perceived Benefits and Barriers of Adherence of Heroin-dependent Patients to Methadone for Addiction Treatment: A Health Belief Model Study
Yu, B., Zhou, J., Gong, Y., Han, J., Dong, P., Yang, S., Liao, R., Guan, P., & Yang, S. (2020) · Journal of Addiction Medicine · doi:10.1097/adm.0000000000000640 · Cited by 23
“Our results corroborated that theory-centered determinants related to beliefs like the HBM are useful (Jones et al., 2014), which may provide different insights for designing effective measures to improve adherence to MAT.”
Result
Moving from Theoretical Principles to Intervention Strategies: Applying the Experimental Medicine Approach
Rothman, A. J., Klein, W. M. P., & Sheeran, P. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108677318.020 · Cited by 26
Effectiveness of modified health belief model-based intervention to reduce body mass index for age in overweight junior high school students in Thailand
Khumros, W., Vorayingyong, A., Suppapitiporn, S., Rattananupong, T., & Lohsoonthorn, V. (2018) · Journal of Health Research · doi:10.1108/jhr-08-2018-0065 · Cited by 22
Behavioral Correlates of COVID-19 Worry: Stigma, Knowledge, and News Source
Meltzer, G., Chang, V. W., Lieff, S. A., Grivel, M. M., Yang, L. H., & Jarlais, D. C. D. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph182111436 · Cited by 20
“Following the Health Belief Model’s presumption that those who were ‘very worried’ would be most likely to take preventive health measures and adhere to public health guidelines [67], we dichotomized COVID-19 into ‘not at all or somewhat’ (ref.”
Mental Health and Adherence to COVID-19 Protective Behaviors among Cancer Patients during the COVID-19 Pandemic: An International, Multinational Cross-Sectional Study
Kassianos, A. P., Georgiou, A., Kyprianidou, M., Lamnisos, D., Ļubenko, J., Presti, G., Squatrito, V., Constantinou, M., Nicolaou, C., Papacostas, S., et al. (2021) · Cancers · doi:10.3390/cancers13246294 · Cited by 21
“COVID-19 is a context where people’s attitudes towards the disease strongly influence how they feel and behave and add to a large body of literature on how the Health Belief Model can be used to understand health behaviors [88,89].”
Background
Application of the Health Belief Model to U.S. Magazine Text and Image Coverage of Skin Cancer and Recreational Tanning (2000–2012)
McWhirter, J. E., & Hoffman‐Goetz, L. (2016) · Journal of Health Communication · doi:10.1080/10810730.2015.1095819 · Cited by 22
Knowledge, attitudes and opinions towards measles and the MMR vaccine across two NSW cohorts
Brieger, D. G., Edwards, M. J., Mudgil, P., & Whitehall, J. S. (2017) · Australian and New Zealand Journal of Public Health · doi:10.1111/1753-6405.12720 · Cited by 22
Imagery, Visualization, and Mental Simulation Interventions
Hagger, M. S., & Conroy, D. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108677318.033 · Cited by 23
Changing Behavior Using the Common-Sense Model of Self-Regulation
Cameron, L. D., Fleszar‐Pavlović, S. E., & Khachikian, T. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108677318.005 · Cited by 29
Nutrition counseling and monitoring via tele-nutrition for healthy diet for people with spinal cord injury: A case series analyses
Wood, S., Khong, C.-M., Dirlikov, B., & Shem, K. (2022) · The Journal of Spinal Cord Medicine · doi:10.1080/10790268.2021.1871824 · Cited by 20
Health belief model and behavioural practice of urban poor towards COVID-19 in Nigeria
Adesina, E., Oyero, O. S., Amodu, L. O., Amoo, E. O., Oyesomi, K., Adeyeye, B., & Yartey, D. (2021) · Heliyon · doi:10.1016/j.heliyon.2021.e08037 · Cited by 27
Causes of medication non-adherence and the acceptability of support strategies for people with hypertension in Uganda: A qualitative study
Wilkinson, R., Garden, E. B., Nanyonga, R. C., Squires, A. P., Nakaggwa, F., Schwartz, J. I., & Heller, D. J. (2021) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2021.104143 · Cited by 21
Sociodemographic Factors Associated With Knowledge and Risk Perception of Human Papillomavirus and Human Papillomavirus–Associated Oropharyngeal Squamous Cell Carcinoma Among a Predominantly Black Population
Osazuwa‐Peters, N., Boakye, E. A., Chen, B. Y., Clancy, J., Vallot, P. L., Su, J., Beck, G. E., & Varvares, M. A. (2016) · JAMA Otolaryngology–Head & Neck Surgery · doi:10.1001/jamaoto.2016.2784 · Cited by 21
“This rationale is consistent with the health belief model,(36)whichstates that susceptibilityor an individual’sperceived risk of being exposed to or having a certain condition influences his or her health-promoting behaviors, including obtaining vaccinations.(37) Therefore, higher HPV risk perception or susceptibility…”
Result
Theories of Health Behavior
Gehlert, S. J., & Ward, T. S. (2019) · Wiley eBooks · doi:10.1002/9781119420743.ch7 · Cited by 24
Engagement of Stakeholders in the Design, Evaluation, and Implementation of Complex Interventions
Hudson, J. L., Moon, Z., Hughes, L. D., & Moss-Morris, R. E. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108677318.024 · Cited by 20

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 › Communication › 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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