Discussion: The Transmission of HIV
Planning Models Models and theories are planning tools that assist with understanding the causes of behaviors, predicting behaviors, and evaluating programs. Models are the starting place on which to build, and they can serve different purposes, which is why so many models exist.Promoting health in a multicultural setting requires using models that take the cultural context into consideration. Two planning models are briefly described here: the Health Belief Model and the PRECEDE–PROCEED model. An in-depth discussion of program planning models is outside the scope of this chapter.
Health Belief Model The Health Belief Model (HBM) is a psychological model that attempts to explain and predict health behaviors by focusing on the attitudes and beliefs of individuals. The HBM was developed in the 1950s as part of an effort by social psychologists in the U.S. Public Health Service to explain
the lack of public participation in health screening and prevention programs (e.g., a free and conveniently located tuberculosis screening project). Their focus was on increasing the use of preventive services, such as chest x-rays for tuberculosis screening and immunizations.
FIGURE 6.2 Health Belief Model.
The developers assumed that people feared diseases and that health actions were motivated in relation to the degree of fear (perceived threat). If the potential benefits outweighed practical and psychological obstacles to taking action (net benefits), they expected that action would occur. The HBM was one of the first models that adapted theory from the behavioral sciences to health problems, and it remains one of the most widely recognized conceptual frameworks of health behavior. The HBM has been adapted to explore a variety of long- and short-term health behaviors, including sexual risk behaviors and the transmission of HIV. The key variables of the HBM are given in Figure 6.2.
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