The Health Belief Model - Assignment Example

HEALTH BELIEF MODEL HOW THE HEALTH BELIEF MODEL CAN IMPROVE THE HEALTH RELATED BEHAVIOURS ON HYPERTENSION OF AFRICAN AMERICAN MEN Abstract The Health Belief Model (HBM) by Rosenstock (1974) has been used as a health behaviour change model to predict the health related behaviour of African American men about hypertension. This model was selected because it offers a preventive approach to health care, which is the hallmark of primary health care. As part of risk factors, hypertension has been identified to affect most African American men in a lot of ways. Meanwhile, this health condition leads to several other health risks including stroke, blindness and heart failure in the same population. It is however a positive development to know that hypertension is preventable if approached from the use of improved health related behaviour including lifestyle modifications on diet and exercises. But to effectively execute such a primary health approach to dealing with hypertension in the identified population, it is necessary to have a theoretical basis that can serve as evidence. Using the HBM made it possible to have four major theoretical constructs based on which there can be variable targets for the improvement of health related behaviours in the areas of attitude to diet and exercising. Literature from three major researchers has become basic evidence of the effect that when exercising and good dietary behaviour are acquired, it will be possible to handle issues of hypertension at the pre-occurrence stage so that the attendant risks associated with the disease will not be experienced by the targeted population. This is because the researchers used the HBM to test variable cases of health conditions and saw that were basic health related behaviours are made to prevail, successes with preventive care is achieved. Introduction The attainment of good health is the ambition of both health service providers and service users. In often cases however, the achievement of this all important ambition is not easily realised. Starfield (2011) noted that major cause of failed health care is the disregard for primary health care. This is because instead of focusing on primary health services that seek a preventive approach to health care rather than a curative approach, most people wait till their health situations become deteriorated before seeking professional help. Meanwhile for most health and clinical conditions, late management and treatment reduces changes of any hopes of guaranteed total care (Starfield, 2011). It is against this background that the need to improve health related behaviours that act as risk factors for various health conditions is very important. In this paper, the Health Belief Model is used as a theoretical intervention to assessing how African American men can improve health related behaviours that put them at risk to acquiring hypertension. Hpertention was selected because of its prevalence among the African American male population. The Health Belief Model (HBM) was also selected due to how preventive it is when applied as a theoretical health intervention, fulfilling the need for primary health care promotion. Overview of Clinical Condition Hypertension among African American males is the clinical condition related to advance nursing practice that is being reviewed in the paper. Hypertension is a health condition that results when the range of systolic and diastolic reading of a person is at or above 140/90mmHg (Fisher and Williams, 2005). Such a condition does not however come out of nowhere. It would be noted that the normal systolic and diastolic reading of person must be in the range of 100-140mmHg and 60-90mmHg respectively (Fisher and Williams, 2005). However, there are times that a medical condition develops, which cause the blood pressure in the arteries of a person to become raised. It is under such medical conditions that the reading of the systolic and diastolic gets out of range, signalling the onset of hypertension. Hypertension is commonly referred to as high blood pressure because of the role of elevated blood pressure in the arteries in this medical condition. Even though hypertension may be a health problem in almost any other person, African American men have been identified to be particularly at a higher risk of contracting the disease (Dionne, Abitbol and Flynn, 2012). Among other things, African American men have also been noted to develop the disease at an earlier age as compared to other Americans (Dionne, Abitbol and Flynn, 2012). The worst of it is that African American men have been identified to develop complications associated with hypertension, including blindness, heart disease and stroke, once they contract hypertension (Web MD, 2014). In a case study by Whelton et al. (2002), it was noted that the African American man has such a peculiar case because of health related behaviours that put them at a higher risk of contracting the disease. Some of the risks are excessive weight, diabetes, inactivity, smoking, and high salt and fats (Web MD, 2014). In effect, any improvement in health related behaviour that puts them away from these risks can prevent hypertension in the population. Summary of the State of Science The overview of the clinical condition concluded that an improvement in health related behaviour can best be used to correct health risks associated with hypertension. Based on this, 3 scholarly articles that offer a theoretical basis to health related behaviour are reviewed. Rosenstock (1974) conducted a primary research in which the health belief model was devised and used as preventive health behaviour. Based on Coughlan, Cronlin and Ryan (2007), the believability of the study by Rosenstock can be critiqued from four major perspectives, namely writing style, author, report style and abstract. Based on these elements, it can be said that Rosenstock’s research can be believed as Rosenstock had displayed his years of professional practice in the field of psychological health by clearly and unambiguously stating the report title. The writing style also made provisions for both professionals and non-professionals to understand and make meaning of the study. All of these were well carried out in the abstract. On the robustness of the research, the study clearly identified the phenomenon of interest as preventive health behaviour. In line with this, a purpose of finding the place of preventive health behaviour in primary health care was clearly made with a literature review that was directly related to the objectives. The theoretical framework used by the researcher was the health belief model (HBM). A weakness with the study, however, had to do with the sample, where the use of non-probability sampling could have aided in identifying people specifically affected by the phenomenon of interest of the stud. What is more, even though there were ethical considerations in the protection of identities of respondents, no clearly stated ethical guidelines were given in the study. These weaknesses notwithstanding, data collection and analysis were both carried out in a very rigorous manner, where a systematic collection and analysis approaches were used by the researcher. After the study, there were clear cut conclusions based on the findings on the need to pursue primary health care ahead of secondary and tertiary health care through preventive health behaviour adjustment. Based on the research of Rosenstock (1974), Rosenstock, Strecher and Becher (1988) undertook a follow-up study on social learning theory and how this theory applies to the use of the HBM. The need for this study was to test the theory of Rosenstock, which was the HBM. This follow up study was rendered much basis for its believability given the backdrop that it was undertaken by three influential and experienced writers in the field of psychological health behaviour. The findings of this study showed that the HBM best functions as a dependent model rather than an independent model. This is because when the model was tested with the social learning theory, it came to light that before a person can have the consciousness to undertake preventive health behaviour, the person must have an influential stimulus in the form of social learning, which triggers such preventive health behaviour. The study can be said to be very robust, given the fact that the statement of phenomenon selected by the researchers was clearly in line with the purpose of the study. The sampling was appropriately made, given the fact that it had both a control and test sample that made it possible to test for internal validity. Several years after Rosenstock’s study, Plowden (1999) also conducted a primary study that used the HBM to tackle a specific health situation among an identified population, which were African American men. The health situation considered was prostate cancer. This was a qualitative study that focused on the conceptual framework of health related behaviour. In line with the qualitative study, which focused on behavioural characteristics of respondents, the impact of health related behaviour was co-related with chances of acquiring prostate cancer, its risk factors and treatment in African American men. Plowden (1999) saw sufficient evidence in the position take earlier by Rosenstock that preventive health behaviour can indeed help in minimising risk and cases of key health conditions. This is because findings from the study showed that respondents who adapted the behavioural change interventions prescribed by the researcher recorded improved health status. The weakness with the robustness of Plowden, however, had to do with the selection of the sample size. As one of the first test cases for the original theory, it was expected that a health condition that is common among patients of both sexes would be used. This way, it would have been possible to build on his study by other researchers by testing the generalisability of his findings among the female population. Based on the approach to the various researches where emphasis was put on primary data collection and guaranteeing the validity of all data collection procedures, it can be said that the reviewed scientific evidence is of high quality. The researchers demonstrated high sense of reliability in data collection, which guarantees the generalisability of the study APN practice (Coughlan, Cronlin and Ryan, 2007). Based on the findings of this evidence, it is possible to deduce other scientific theories and hypotheses that can be built upon for further research and analysis. These evidences also offer comprehensive guidelines to modern nursing practice on how the HBM can be used to deal with prevailing health conditions such as hypertension. Rosenstock's Health Belief Model The Health Belied Model (HBM) is classified as one of the most used health models in public health education (Champion, 1984). With this model, a psychological approach to health behaviour change is taken, whereby health related behaviours of a person or group of people are explained and predicted (Champion, 1984). The model has been considered very appropriate for public health education because it is client centred and highly qualitative in nature, making it easily applicable with most forms of behaviour based health events. In most cases, applicants of the model seek to apply it in terms of how willing a person or group of people are in taking health services. In effect, the HBM can be said to take preventive approach to health care and thus used for the promotion of primary health care. Developed by Rosenstock the model works by measuring behavioural outcomes in seven major areas of the respondent’s health behavioural variables. These seven behavioural outcomes are the basis of seven major theoretical constructs, which are perceived severity, perceived susceptibility, perceived benefits, perceived barriers, modifying variables, cues to action, and self-efficacy. Under the application of theory to nursing practice, these seven areas are discussed in relation to how they can be used to control hypertension in African American men. Application of Theory to Nursing Practice To effectively apply the HBM, Glanz, Marcus and Rimer (1997) summarised a table for the theory, out of which a conceptual model was developed. This table is presented below. Source: Glanz, Marcus and Rimer (1997, p. 17) From the table above, Glanz, Marcus and Rimer (2002) devised a conceptual model that simplified the HBM into three major aspects, given as individual perceptions, modifying factors and likelihood of action. To apply the HBM and its conceptual model to hypertension in African American men, the following can be made. On the individual perceptions, African American men must have a higher perception of the seriousness of hypertension as a health condition that has some peculiar features with that population that is highly unfavourable. Prominent among these is the fact hypertension can lead to several other health risks including stroke, blindness, kidney disease, dementia and heart disease (Wed MD, 2014). In terms of modifying factors, the perceived susceptibility of the disease would lead to an understanding of the perceived threat of the disease, which includes sudden death and breakdown from regular ways of going about normal life. With the threats well noted, respondents within the population can modify their health related behaviour that has to do with personality and lifestyle modifications. But before these lifestyle modifications can take place, it is expected that cues to action including public education, visible disease symptoms and media information will be used to equip the knowledge of respondents on the best actions to take towards controlling the disease. The said lifestyle modifications will also occur only after a state of sampling identity using variables such as age and socio-economic knowledge. This is because with hypertension, Fisher and Williams (2005) noted that the risk of contracting the disease increases with increasing age. The said lifestyle modification will have a direct correlation with the likelihood in action, especially likelihood in behavioural change. Based on evidence from Fisher and Williams (2005) on lifestyle modification that can bring about first line of treatment, mention is made of dietary changes, physical exercise and weight loss. Once these lifestyle modifications are used, an added advantage is that it can actually promote prevention in populations who are not already exposed to the disease. Based on the HBM therefore, the outcome that can be achieved in African American men is not only the non-medicated treatment of hypertension but also the prevention of disease. Comparatively, the perceived benefits will far outweigh the behaviour barriers, as the lifestyle modifications recommended are not ones that are difficult to implement. Conclusion The paper has been an important academic exercise in contributing to both academic and professional practice. This is because the paper was conducted in a manner that critically reviewed an existing theory and at the same time critiqued the theory as a way of filling major theoretical gaps associated with the theory. In terms of professional practice, the paper has been very instrumental in identifying the place of primary health care as the most workable solution to meeting the health needs of the general public and particularly patients. Based on the key findings of the paper, it can be concluded that the HBM is an important health model that meets the requirements of preventive health care and is thus ideal for improving health related behaviours in African American men that put them at risk of getting hypertension. This is because basing on the four major theoretical constructs of the model, the population of African American men can be better predicted of their health behaviour and readiness to take health services aimed at keeping them away from acquiring hypertension. Once this prediction of health-related behaviour is successfully done, it is easier to prescribe improved lifestyle modifications that can ensure that these people live free from hypertension. References Champion, V.L. (1984). Instrument development for health belief model constructs. Advances in Nursing Science, 6, pp. 73–85. Coughlan M., Cronin P. and Ryan F. (2007). Step-by-step guide to critiquing research. British Journal of Nursing, 16(11), pp. 658–63. Dionne J.M, Abitbol C.L and Flynn J.T (2012). Hypertension in infancy: diagnosis, management and outcome. Pediatr. Nephrol., 27(1), pp. 17–32. Fisher N. D. and Williams G.H. (2005). Hypertensive vascular disease (16th ed.). New York, NY: McGraw-Hill. Glanz, K., Marcus L. F. & Rimer, B.K. (1997). Theory at a glance: a guide for health promotion practice. New York: National Institute of Health. Glanz, K., Rimer, B.K. & Lewis, F.M. (2002). Health behavior and health education. theory, research and practice. San Fransisco: Wiley & Sons. Plowden, K. (1999). Using the Health Belief Model in understanding prostate cancer in African American men. ABNF Journal, 10(1), pp. 4–8. Rosenstock, I. M. (1974). The health belief model and preventive health behavior. 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