The health belief model: can it help us to understand contraceptive use among adolescents?
Herold, E.S.
Journal of School Health 53(1): 19-21
1983
ISSN/ISBN: 0022-4391 PMID: 6550149 DOI: 10.1111/j.1746-1561.1983.tb04047.xDocument Number: 392540
The objective of this discussion is to show how the Health Belief Model (HBM) can be applied to family planning in general, and in particular to the use or nonuse of contraception among sexually active young females. Katatsky has argued that the HBM should be used to guide family planning research, but the shortcoming of her article is that she fails to go into detail regarding how the specific concepts of the HBM would be useful. The attempt in this is made in this discussion to go beyond Katastky's general statement. Her main argument for use of the HBM is that it focuses on the role of motivating factors in the prevention of health problems. This is particularly relevant in understanding the birth control practices of teenagers, for whom motivational factors are more important than lack of knowledge in inhibiting the use of contraception. The HBM assumes that motivation is a necessary condition for action. The 2 major components of motivation in the HBM are perceived susceptibility and perceived severity. In the family planning area, perceived susceptibility refers to the perceived risk of becoming pregnant and is an important factor explaining the use or nonuse of contraception particularly among adolescents. Lack of perceived susceptibility to pregnancy can result in risk taking, but risk taking itself can lead to lowered feelings of susceptibility. The HBM assumes that the more serious a health problem is viewed, the more likely one is to take preventive action against it. Research has consistently shown that contraceptive effectiveness rates for couples who have definitely decided not to have any more children is considerably higher than for those couples who only want to delay the next pregnancy. Research with unmarried women has shown that those who have high educational and career goals are more likely to practice effective contraception than those who give priority to motherhood over a career. According to the HMB, before taking preventive health actions, persons weigh the perceived benefits of the health action against the cost of taking the proposed actions. There are major costs of using contraceptives that are not method specific. These include the reluctance to plan ahead for sexual intercourse and the cost of admitting to others that one is sexually active. Other costs are method specific. The final major concept of the HBM is a cue to action that stimulates preventive behavior. Cues could be internal (coming from within the individual) or external (coming from others). An internal cue could be a delayed menstrual period.