Statistics from the National Health and Nutrition Examination Survey (NHANES) 2005-2006 indicates that obesity in the United States continues to increase at an alarming rate (Moore, Harris & Wimberly, 2010). The survey estimated that more than 72 million Americans are obese. The increased prevalence of overweight and health complications related to it is a clear indication that obesity has become a public health issue in the United States. Although public health agencies have produced reports on the country’s obesity state, it is yet to be clear whether or not most of the obese people are aware that they are overweight and whether they are aware of the risks of being obese (Moore, Harris & Wimberly, 2010). Much research has been conducted to investigate the major causes of the increasing prevalence of obesity in America. Most researchers, if not all, have concurred that unhealthy behaviors are the major contributing factors to obesity especially among the adolescents and the women. Obesity among the adolescents has become more widespread, for example, due to the fact most of them spend much of their time playing video games and watching television instead of engaging in regular physical activities. People who have adopted such unhealthy behaviors may become overweight and experience other medical complications like diabetes and high blood pressure (Romano & Scott, 2014). Vast researchers have sought to determine whether or not there are any health models that could be used to decrease of obesity especially among the children and the youth. Much public awareness has been created to sensitize the importance of adopting healthy behaviors that reduces the risks of acquiring obesity and other serious medical conditions that may cause death. Apart from public awareness, I think that it is important for medical practitioners to adopt health theories that would assist in understanding the issue of health behaviors in relation to obesity. As an intervention measure for decreasing obesity in the United States, I would propose the Health Belief Model (HBM) as an evidence-based health model that could be useful in decreasing overweight among the people. The proposed model promotes and instills healthy behaviors that help in preventing and reducing obesity.
Understanding the Health Belief Model
Health Belief Model (HBM) is a health model which was first introduced in the 1950s, by a group of social psychologists from the United States Public Health Services (Romano & Scott, 2014). The social psychologists included Kegels, Hochbaum, and Rosenstock. It was developed following the failure of a health screening program for tuberculosis. Since its launch, the HBM has assisted practitioners in the field of psychology to explore health behaviors associated with certain diseases. The model is also useful in the nursing practice, especially when dealing with issues relating to preventive care practices.
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The psychological health model attempts to address the connection between people’s behaviors and their beliefs or perceptions. It posits that the health-related behaviors of an individual depend on his or her perception on such issues as the severity of a particular illness (assessment of potential consequences involved) and vulnerability to the disease (assessment of the risk of acquiring the condition). They also depend on the benefits associated with taking preventive measures and the barriers involved in taking those actions (Romano & Scott, 2014; Tuzavo, 2009). As such, the model is important as it helps practitioners understand and predict the behaviors adopted by people in relation to health. It is also useful because it assists in predicting how people will comply with various health care practices (Tuzavo, 2009).
The model has developed to encompass the constructs of perceived costs and mediating factors (Tuzavo, 2009). Perceived costs, in this case, refer to accessibility and complexity associated with complying with the proposed treatment of proposed intervention. Mediating factors include health motivation, demographic factors like age and gender as well as socio-psychological factors like personality and socio-economic status. Mediating factors of the HBM also include perceived efficacy (self-assessment on the ability to adopt a certain behavior), cues to action (external factors that would promote the adoption of the desired behavior), perceived threat (danger involved if failure to adopt the desired health behavior) and perceived control (Tuzavo, 2009). Using these constructs, it would be reasonable to argue that the Health Belief Model predicts whether or not a person is likely to adopt a certain behavior for improving health.
Application of HMB in decreasing obesity
According to Tuzova (2009), most of the public health issues experienced today occur as a result of unhealthy behaviors. Obesity is one public health problem in the US whose prevalence has increased as a result of people’s unhealthy behaviors. Examples of unhealthy behaviors that have contributed to the increase of obesity especially among the children include adopting unhealthy diet and lack of physical activities (Tuzova, 2009). Studies conducted in the 1990s indicated that such unhealthy behaviors contributed to more than 40% of deaths in America (Tuzova, 2009). With the aim of reducing the mortality associated with unhealthy lifestyle choices, professionals in the health care sector have sought to use behavior change health models as a guide for developing strategies that help in reducing behaviors that increase risks of contracting diseases. They also use health models to develop strategies that promote self-protection action and assist in adapting to illnesses. This section will use the various constructs of the Health Belief Model to demonstrate how it can influence the decrease of obesity.
HBM has, for many years, been used as a theory of promoting health through such areas as smoking cessation, exercise programs as well as nutrition programs. As stated earlier, adoption of a health behavior depends on an individual’s perception of a certain disease and the options available for decreasing the occurrence of that particular disease. Professionals often use the theoretical constructs of HBM to understand, explain and predict health-related behaviors that people are likely to adopt (Tuzavo, 2009). Now, let’s look at how these constructs can influence the decrease of obesity.
Perceived severity is a construct that is based on the knowledge or medical information that an individual may have concerning obesity. It may also depend on an individual’s beliefs about the difficulties or consequences associated with being overweight. For example, most obese people believe that being overweight is normal, especially if the obesity runs in the family. What’s more worrying is that the fact that most of them are not aware that being overweight would result in other medical complications that would see them in a hospital. As such, such individuals are less likely to adopt healthy behaviors that would help reduce their obesity. The number one health complication associated with being overweight is cardiovascular disease (Moore, Harris & Wimberly, 2010). In one study conducted by the Center for Disease Control and Prevention in the year 2003, it was estimated that cardiovascular disease accounted for about 28% of the deaths in America that year (Moore, Harris & Wimberly, 2010). From these statistics, it is no doubt that obesity is a serious disease that would cause death through the various complications associated with it. Taking into consideration the health complications associated with obesity would influence an individual’s perception of the seriousness or severity of being overweight. As a result, he or she is more likely to adopt a healthy lifestyle to reduce his or her obesity.
Perceived susceptibility influences people’s perceptions and prompts them to adopt healthy behaviors that are likely to reduce their risks of becoming obese. Studies show that obesity varies depending on age, gender, ethnicity and social class (Tuzavo, 2009). Children, for instance, are perceived to be more prone to becoming overweight than the adults as most of them are not aware of the health-promoting behaviors of maintaining or reducing body weight. On the category of ethnicity, ethnic minorities like the African Americans are more prone to becoming obese as they experience poor health and do not have access to quality health care (Romano & Scott, 2014). Therefore, when people perceive themselves as more susceptible to obesity, they are more likely to develop strategies that would help decrease their risk of becoming overweight. Perceived susceptibility would motivate a person, for example, to walk to his or her workplace instead of using a car. Increased perceived susceptibility and increased perceived severity would result in increased perceived threat. As stated earlier, obesity is a serious condition that has high risks of other health complications. It is this perceived threat of obesity-related complications that motivates people to adopt healthy behaviors like improving diet and exercising regularly.
The construct of perceived benefits influences an individual’s perception of the value of adopting lifestyle behaviors that decrease the risk of becoming obese. This means people are more likely to adopt certain new behaviors if they believe that those behaviors help in decreasing their likelihood of being overweight. For example, it is logical that a person would strive to consume vegetables at least twice per day if he or she believed that doing so is beneficial in relation to maintaining normal body weight. Likewise, an individual would strive to go to the gym at least three times a weekly if he or she believes that doing so add value in efforts of decreasing obesity. It is important to note that some people believe that exercise is beneficial in decreasing obesity while others do not. As such, individual who have added value on physical exercises are more likely, than others, to engage in regular physical activities like walking, swimming, playing soccer and lifting weights at the gym.
It is worth noting that adopting a new behavior that one is not used to, poses some challenges. The challenges associated with adopting any new behaviors are referred, under the HBM, as perceived barriers (Tuzavo, 2009). Adopting new behaviors for decreasing obesity could be one of the most challenging moments for the overweight people. An individual, for instance, would face obstacles when trying to cope with regular exercises at the gym. To adopt a new behavior that would help in decreasing obesity, it is important for an individual to believe that the advantages of adopting that behavior outweigh the disadvantages of maintaining old behaviors that are not aimed at decreasing overweight. By doing so, one can overcome the barriers to adopting the new behavior.
Modifying variables and cues to action are other HBM constructs that can influence the decrease of obesity. According to Health Belief Model, modifying variables include such individual characteristics as skill, motivation, past experience, culture and level of education (Tuzavo, 2009). For example, if one was obese during childhood and has a reduced body weight during adulthood, he or she may have an increased perception of susceptibility owing to his or her past experience. Due to this past experience, the person is more likely to maintain his or her health behaviors of decreasing obesity or adopt new ones. Likewise, people with advanced education levels are more likely to adopt new behaviors aimed at decreasing obesity because they are more aware of risks involved in being overweight.
Cue to actions are the things or people that influence or motivate an individual to adopt a new behavior aimed at promoting health, in this case, reducing obesity. Examples of such things include, among others, advice from others, media reports and awareness campaigns (Tuzavo, 2009). Obtaining advice from friends and family members on the importance of eating a healthy diet would motivate an individual to adopt healthy eating as a behavior aimed at decreasing obesity. Hearing television news about causes and risks of obesity would also motivate a person to adopt behaviors that would be helpful in reducing obesity.
Conclusion
It is no doubt that obesity is a public health problem that continues to affect most of the American population. From the paper, it is clear that most of the public health issues experienced today occur as a result of unhealthy human behaviors. The Health Belief Model is one health model that practitioner continue to use in understanding, explaining and predicting people’s health behaviors. Through its theoretical constructs, the HBM plays a significant role in influencing people to adopt behaviors aimed at decreasing obesity. To avoid being overweight, individuals ought to adopt a healthy lifestyle that includes physical exercises and having healthy diet. People should seek information on the risk factors for obesity and the consequences involved in being overweight to adopt healthy behaviors for avoiding the same.
References
Moore, S. E., Harris, C., & Wimberly, Y. (2010). Perception of weight and threat to health. Journal of the National Medical Association , 102 (2), 119.
Romano, V., & Scott, I. (2014). Using Health Belief Model to Reduce Obesity Amongst African American and Hispanic Populations. Procedia-Social and Behavioral Sciences , 159 , 707- 711.
Tuzova, M. (2009, December). Health belief model: losing a battle against obesity. Retrieved from https://www.researchgate.net/publication/265048468_Health_belief_Model_losing_a_bat tle_against_obesity
