Models in health psychology: an introduction

Health belief model The health belief model (HBM) is a cognition model, i.e. a model that emphasises the way an individual provides a rationale for their behaviour without particular reference to a social context. The HBM was conceived by Rosenstock (1966) and has undergone revision and development, primarily by Becker (1974). It has made an important contribution to the prediction of health What makes some people more able than others to lose weight? Why are some people better motivated to perform blood glucose monitoring? What makes some people more able to cope with distressing situations? What factors contribute to the development of depression? How can one possibly predict whether a person newly diagnosed with diabetes will manage the demands of the condition? These are the type of questions typically addressed in health psychology — the study of how psychological factors such as beliefs, values, thoughts, feelings and attitudes impact on health and illness and health-related behaviours. Health psychology is a relatively new discipline, emerging in the context of a challenge to traditional biomedical models of illness. Briefly, these traditional models see illness as arising from external forces (e.g. bacteria) over which the individual has no control. There is no continuum between mental and physical aspects of illness and the two are regarded as entirely separate. Treatment is solely in the hands of the healthcare professional. By contrast, health psychology views mental processes as not only intertwined with physical processes in illness, but also as a potential contributory factor to both health and illness. The individual is seen as having an active, rather than passive, role in the cause, progression and outcome of illness. The biopsychosocial model (Table 1) illustrates how these various components interact. Introduction This article, the first in a series on health psychology, introduces the subject and some of the models which seem particularly relevant to diabetes care. These include the health belief model, the health locus of control model, the theory of planned behaviour, and the transtheoretical theory of behaviour change. Examples of how these theories apply directly to the care of patients with diabetes are explored. The intention is to promote greater insight, further reading and, hopefully, future application of the theories in research studies.