Health Belief Model
The Health Belief Model (HBM) was developed in the 1950s by behavioral scientists from the US Public Health Service (Green et al., 2020). Since its development the HBM has been used frequently in the health behavior research around the globe; over the decades the model has been expanded and modified numerous times. The HBM studies the likelihood of a person taking action to reduce risks to their health based on six main factors: perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, and self-efficacy.
Strength
The HBM has a substantial empirical support from multiple studies that support the theoretical implications of the model (Glanz et al., 2008).
The HBM can be effectively combined with other programs and models further increasing the effectiveness of studies and interventions (Saywell et al., 2003; Weinstein, 1993).
The HBM is flexible and can be adopted in numerous health-related spheres as its main constructs are universal.
General simplicity of the HBM concept makes it relatively easy to apply and use within different researches and interventions.
Weaknesses
Variability in measurement of the primary HBM constructs is substantial; therefore, a lot of effort has to be directed towards calibrating the definitions, measurements, and overall reliability and validity of each study conducted (Glanz et al., 2008).
Relationships between constructs within the HBM can affect and alter the interventions in various unexpected ways and they require further research and testing (Glanz et al., 2008).
The HBM does not take into account the emotional component of human behavior; therefore, the predictable power of the model is reduced (Glanz et al., 2008).
Cues to action is a complicated factor to consider, measure, and add to the research or intervention; thus, their impact on the final results can be underestimated (Saywell et al., 2003).
Transtheoretical Model
The Transtheoretical Model (TTM) studies stages of change to “integrate processes and principles of change across major theories of intervention” (Glanz et al., 2008, p. 97). The TTM is the result of an effort to integrate the fragmented field of behavior change theories. According to TTM, there are six main stages of change: precontemplation, contemplation, preparation, action, maintenance, and termination.
Strength
There is strong evidence confirmed by numerous researches that TTM is effective for changing health behaviors (Hashemzadeh et al., 2019). This is also relevant for chronic diseases; such areas as obesity and sclerosis serve as examples.
The TTM integrates numerous previous behaviors change theories, which allows the model to use the advantages of its predecessors, and work out their disadvantages.
The TTM can be used for a broad range of health and mental health behaviors, including substances abuse, anxiety, bullying, depression, etc.
TTM-based interventions can be effective within interdisciplinary strategies, combined with usual care, for instance (de Freitas et al., 2020).
Weaknesses
The TTM is limited in the area of prevention of substance abuse in children – population trials did not produce any significant prevention effects (Glanz et al., 2008).
There is an argument that the TTM oversimplifies behavior change process as it creates “arbitrary categories related to arbitrary definitions” (Vilela et al., 2009).
The TTM provides descriptive means of understanding addictive behavior – it focuses on how the process of change should be, rather than providing prescriptive means (Vilela et al., 2009). Prescriptive means define how the behavior really is and how it can be induced.
The TTM may require careful adaptations to different cultures, as it was only tested in ten countries of the world (Glanz et al., 2008).
Opportunities
Further separate research of independent variables within the TTM can “potentially provide insight into the content of behavior change interventions” (Armitage, 2009, p. 203).
Threats
There is some evidence that an alternative model – two-phase motivational-volitional model – considers and predicts the behavior change process better than TTM (Armitage, 2009).
A new theory of the change process – Plans, Responses, Impulses, Motives and Evaluations (PRIME) is declared to advance the ideas of the TTM further; therefore, being more comprehensive (West, 2005).
References
Armitage, C.J. (2009). Is there utility in the transtheoretical model? British Journal of Health Psychology, 14, 195-210. doi: 10.1348/135910708X368991.
de Freitas, P.P., de Menezes, M.C., dos Santos, L.C., Pimenta, A.M., Ferreira, A.V.M., & Lopes, A.C.S. (2020). The transtheoretical model is an effective weight management intervention: A randomized controlled trial. BMC Public Health, 20. doi:10.1186/s12889-020-08796-1.
Glanz, K., Rimer, B.K., & Viswanath, K. (Eds.). (2008). Health behavior and health education: Theory, research, and practice (4th ed.). Jossey-Bass.
Green, E.C., Murphy, E.M., & Gryboski, K. (2020). The health belief model. The Wiley Encyclopedia of Health Psychology, 211-214. doi: 10.1002/9781119057840.ch68.
Hashemzadeh, M., Rahimi, A., Zare-Farashbandi, F., Alavi-Naeini, A. M., & Daei, A. (2019). Transtheoretical model of health behavioral change: A systematic review. Iranian journal of nursing and midwifery research, 24(2), 83–90. doi: 10.4103/ijnmr.IJNMR_94_17.
Saywell, R. M., Jr, Champion, V. L., Zollinger, T. W., Maraj, M., Skinner, C. S., Zoppi, K. A., & Muegge, C. M. (2003). The cost effectiveness of 5 interventions to increase mammography adherence in a managed care population. The American journal of managed care, 9(1), 33–44.
Vilela, F. A., Jungerman, F. S., Laranjeira, R., & Callaghan, R. (2009). The transtheoretical model and substance dependence: Theoretical and practical aspects. Revista brasileira de psiquiatria, 31(4), 362–368.
Weinstein, N. D. (1993). Testing four competing theories of health-protective behavior. Psychology, 12(4), 324-333.
West, R. (2005). Time for a change: Putting the Transtheoretical (Stages of Change) Model to rest. Addiction, 100(8), 1036-1039.