Health Belief Model

The current recommendation is that women over the age of 40 should receive a mammogram every 1-2 years (Kidd, Colbert & Jatoi, 2015). Breast cancer mortality is higher in ethnic minorities including, Blacks, Hispanics, and Native Americans (O’Keefe, Meltzer, & Bethea, 2015). With Black, Hispanic, Asian, and White women with breast cancer in a low socioeconomic status, there is also an association with higher mortality rates (O’Keefe et al., 2015). The causes for these disparities is multifactorial and include knowledge deficit, incorrect perceptions about cancer, embarrassment, and prioritization of competing personal obligations, such as working or taking care of family members (Nonzee, et al., 2015). To add to the problem, minority women are much more likely to have high deductible insurance plans, or no insurance coverage at all (Tangka, et al., 2017). These issues lead to later stages of diagnosis of breast cancer, going longer between mammograms, lack of follow-up after suspicious findings on mammograms, and once diagnosed, incomplete treatment of breast cancer (O’Keefe et al.,

The Health Belief Model is commonly used for health promotion and health education. Its’ underlying concept is that health behavior is explained by perception of the disease and the strategies available to lower its occurrence. There are four perceptions of the HBM, which are perceived seriousness, perceived benefit, perceived susceptibility and perceived barriers. In addition to that, more constructs are added to health belief model that includes motivating factor, cues to action and self-efficacy. Each of these constructs in combination or individually, could be used to determine health behavior. The HBM also provides guidelines for the program development allowing planners to address reasons for non-compliance with recommended health action. The health belief model is a process used to promote healthy behavior among individuals who may be at risk of developing adverse health outcomes. A person must gauge their perceptions of severity and susceptibility of developing a disease. Then it is essential to feel vulnerable by these perceptions. Environmental factors can play a role as well as cues to action such as media, and close friends. In order to determine that taking action will be meaningful, the benefits to change must be weighed, against the barriers to change behavior (Green & Murphy, 2014).

This will explore the role gender, ethnicity, race and socio-economics play in the acquisition, maintenance and experience of health care. A particular focus is the interaction (intersection) between these elements and their effect on awareness, education, active prevention and early detection of cancer, particularly breast cancer in women. Cancer is a disease caused by a mutation and rapid division of cells. Cancer is a general term describing many diseases; essentially there is a wide array of types of cancers. This vast differentiation makes it difficult to combat this disease and similarly the differences among individuals cause the course of this disease to vary greatly, cancer effects people differently. Breast cancer is one of the more well-known forms of cancer and is frequently touched upon or glazed over in discussion. A conversation may start with “I know someone who has or had cancer” but way to often this is where the conversation ends. The discussion on breast cancer needs to expand, to further the spread of information and understanding of the many aspects of this disease. “Breast cancer is a malignant tumor that starts in the cells of the breast. A malignant tumor is a group of cancer cells that can grow into (invade) surrounding tissues or spread (metastasize) to distant areas of the body” (What is Breast cancer). Breast cancer can be found in both male and female populations but it is particularly, prevalent among women, Breast cancer is the most pervasive

The Health Belief Model (HBM) of health behaviour change was originally developed in the 1950s in order to understand and explain why vaccination and screening programs being implemented at the time were not meeting with success (Edberg 2007). It was later extended to account for preventive health actions and illness behaviours (Roden 2004). Succinctly, it suggests that behaviour change is influenced by an individuals’ assessment of the benefits and achievability of the change versus the cost of it (Naidoo and Wills 2000).

Low income neighborhoods are still witnessing a rising gap in healthcare coverage. For example, patients with diabetes are more likely to undergo limb amputation than those in higher income areas (Pearl, 2015). Also, research has shown the Caucasians women have and overall incidence of breast cancer that is higher than that of African American women (Williams, Mohammed, Leavell, & Collins, 2010). On the contrary there is a higher death rate of breast cancer in African American women than in Caucasians women.

Kratzke, C., Vilchis, H., & Amatya, A. (2013). Breast cancer prevention knowledge, attitudes, and behaviors among college women and mother-daughter communication. Journal of Community Health, 38(3),

Disparities of all kinds exist in modern day health care. One such disparity that is of particular interest is one that exists between Caucasian and African American women relating to their respective rates of breast cancer incidence and breast cancer survival. According to the American Cancer Society, Caucasian women have a higher incidence of breast cancer than African American women however; Caucasian women have a higher survival rate than African American women (ACS, 2006, as cited in Leshner, 2006). This is to say that although Caucasian woman have a higher rate of breast cancer compared to African American women, Caucasian women have a higher rate of survival. This finding is indeed a disparity in heath care, and one that begs the question as to why this is so. The reasons as to why this disparity exists are numerous and very complex. Several factors play a role in substantiating the disparity in mortality rates related to breast cancer in African American women, including differences in spirituality and religion, differences in education surrounding breast cancer, and differences in socio economic standing as it relates to ones health promotion

Findings in a report with dates from 1975-2003 reported “data on socioeconomic status (SES), behavioral risk factors, and cancer screening by race, ethnicity, and Mexican, Puerto Rican, and Cuban groups”2. Not having access to healthcare is one of the leading factors of why cancer rates among the Hispanic/Latino population is so high. In fact, “Latinos are less likely than non-Latinos to have health care coverage, especially when they are younger than 65 years”2 because of their income. And “Hispanic persons are much less likely to have a regular source of medical care than are non-Hispanic populations, with Latino men being the least likely”2. “Access to state-of-the-art, quality cancer care is known to be unequal and to exacerbate existing disparities in cancer outcomes”2 which is unfair and

In 2010, 14,045 new breast cancer cases were diagnosed among females in Florida and 2,824 females died from it ("Florida Department of Health," n.d.). The incidence and mortality rates were higher among females 65 years of age and older than among females less than 65 years of age. Of all breast cancer cases diagnosed in Florida during 2010, 35.2% were diagnosed at an advanced stage. Florida takes a comprehensive approach in implementing cancer control efforts to reduce disparities, morbidity, and mortality associated with this disease ("Florida Department of Health," n.d.). The Florida Cancer Plan includes 4 goals of addressing the state’s cancer control structure; cancer prevention; diagnosis, treatment and access to cancer care; and cancer

The healthy belief method was demonstrated with this study. The study demonstrated that the impact of health beliefs on behavior showed a direct relationship between health

In today’s society, women are not getting their mammograms done because they feel they are not necessary or because they are afraid of the results of the mammograms. Since women do not get their mammograms done, they are exposed to breast cancer. According to the National Cancer Institute, women who get mammograms, reduce about “15% to 20% in mortality from breast cancer” (“National Cancer Institute” 1). If women would increase the rate of getting mammograms, there will be less deaths in women.

Both the health belief model (HBM) and theories of reasoned action/planned behavior (TRA/TPB) are two model that has their root from psychology. Both models rely on social cognition as a mechanism to change individuals’ behaviors. Opponent criticizes the models for being unable to target social influence outside of an individual and overlook difference between target audiences.

Conner and Norman, 1995 describe the health belief model as ‘the oldest and most widely used model in health psychology’. It originated in the 50’s and was developed further by Hochbaum, Rosenstock and Kegals throughout the 1980’s for health education programmes and to predict different health behaviours and responses to treatments. The four terms that are the basis for the HBM are perceived susceptibility, perceived barriers, perceived severity and perceived benefits. The behaviour of the individual depends on their belief that they are susceptible to a health problem, how serious they deem it to be, whether they think that treatment will benefit them and if there are barriers that may get in the way.

The Health Belief Model (HBM) is one of the first theories of health behavior. It was developed in the 1950s by social psychologists in the U.S. Public Health Services to better understand the widespread failure of tuberculosis screening programs. Today it continues to be one of the most widely used theories. Research studies use it to explain and predict health behaviors seen in individuals. There is a broad range of health behaviors and subject populations that it is applied in. The concepts in the model involve perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, and self-efficacy. Focusing on the attitudes and beliefs of individuals being studied create an understanding of their

Despite the difficulty, researchers have reported the benefits of screening. The most recognized benefit of health screening according to Durojaiye, (2009) is it’s effectiveness in reducing morbidity and mortality from disease by detecting it before symptoms occur. A report in 2006, by the Advisory Committee on Breast Cancer Screening, shows that screening saves 1,400 lives a year in England. In Australia, The age-standardized breast cancer mortality rate in women of all ages declined significantly from 28 per 100,000 women in 1996 to 24 per 100,000 in 2005. Mortality from breast cancer among women aged 50-69 was reported to have declined from 62 deaths per 100,000 in 1996 to 52 deaths per 100,000 in 2005 (Australian Institute of Health and Welfare, 2008) . Evidence also suggests that a reduction in death rates of around 95% is possible in the long-term with cervical cancer screening. The screening of pregnant women to identify and intervene early with risks to their health and that of their babies are associated with improved health status among high-risk populations (Durojaiye, 2009). The idea of screening therefore is to prevent, not to cure. Pope (1992), stats that screening is the second best option, but one which