There are several theories on defining and changing patients’ behavior in order to achieve positive outcomes. Many such theories, including the Health Belief Model (HBM), take a preventive approach that focuses on motivating people to adhere to healthy lifestyles. HBM is a critical tool for nurses and physicians that aim to reduce the health risks of their patients through long-term behavioral changes that gradually shift their lifestyle choices to healthy ones (“The health belief model,” n.d.). This paper will apply HBM to the case presented below, provide a plan of action, overview its implementation, and draw conclusions based on the outcomes of this intervention.
Overview of the Model
HBM is an essential theory for changing the behavior of both individuals and communities through motivation and education, rather than a direct impact. This model was developed in the 1950s by social psychologists from the United States who sought to connect one’s lifestyle choices with health outcomes (“Health belief model,” n.d.). Their research led to a deeper understanding of the patients’ motivation behind compliance, willingness to be cured, and self-regulation.
There are four key concepts on which this model is based. The patient must:
- perceive their susceptibility to the illness;
- perceive the severity of their illness;
- perceive the benefits and barriers to its prevention and treatment;
- receive a cue to action, either from an external or internal source (Frenn & Whitehead, 2021).
Evidence was collected to support this theory in multiple settings. It has been discovered that HBM is applicable for different populations, illnesses, and lifestyles (“Health belief model,” n.d.). As a result, this theory has gathered a significant amount of support throughout the past decades for its efficiency. This model is especially beneficial for people with chronic illnesses whose effects can be alleviated through behavioral changes (“Health belief model,” n.d.). Educational programs turned out to be the primary choice for many HBM programs, while some healthcare professionals started providing personal assistance with the development and adherence to such interventions (“Health belief model,” n.d.). HBM highlights the fact that people are actively seeking ways to become healthy once they realize their illness status.
Brief History of the Patient’s Problem
The patient for this case study is a 54-year-old male with a body mass index (BMI) of 31.3. His diagnoses at the beginning of the planned intervention were hypercholesterolemia and prediabetes. He has a family history of heart disease and diabetes, which contribute to his perceived susceptibility to these illnesses. It is also vital to note that the patient felt that he was at a high risk of getting severe diseases since his dad, who was also overweight, had COPD, CVD, and DM. The initial external cue to action was sparked by the loss of his father. This perceived susceptibility to the illness is a major factor in one’s decision to adhere to the intended intervention (Frenn & Whitehead, 2021). The patient was highly cooperative and self-motivated due to the fear of severe disabilities or death stemming from his excessive weight.
Plan of Action
To provide meaningful assistance for the patient, I intended to educate and support him over the course of 10 weeks. First of all, I needed to outline the necessary adjustments. Changes in one’s lifestyle are an essential part of any obesity treatment (Olson et al., 2017). During the first four weeks, a gradual shift from unhealthy dietary choices had to be made. This change included the reduction in carbs and sugars, zero consumption of fast food, and an increase of vegetables and lean meat in the patient’s diet.
The second part of the intervention was to begin working on the patient’s exercise schedule. The primary goal of HBM commonly consists in explaining how the benefits of exercises outweigh their costs (Villar et al., 2017). The gradual scale of the intensity of physical exercises is a crucial part of HBM for obesity treatment. Studies recommend beginning exercises from 50 minutes/week and increasing their duration to at least 150 minutes/week while decreasing intake of energy-dense food, such as fast food (Olson et al., 2017). Moreover, four long-term goals were outlined: the reduction of A1c, cholesterol, BMI, and improving the performance of the patient’s cardiovascular system.
Implementation of the Health Belief Model
From the very beginning, the patient has acknowledged the susceptibility and severity of his illness yet required assistance with overcoming barriers to treatment and additional cues to action. The primary goal of HBM related to obesity commonly consists in explaining how the benefits of exercises and dietary changes outweigh their expenses and potential initial dissatisfactions (Villar et al., 2017). A similar HBM-based program that consisted of educational courses on dietary changes and physical exercises for people who sought to become healthy has shown its significant potential for improvements (Shao et al., 2018). During the first month, the patient was taught how to control his calory intake, measure blood sugar, and choose healthy foods. Exercises in a gym were selected as the primary physical activity. It was clear that the patient was highly motivated to lead a healthier life, especially since the first signs of his improvements began to appear by week 4.
To assist with his progress, I continuously coached the patient on his dietary choices, physical activities and assisted with measuring improvements. Starting from week 5, his reports of barriers to a healthy lifestyle received immediate feedback as I helped the patient to make the right choices. The patient’s confidence in the success of the intervention was crucial to uphold through continuous feedback on the improvements and additional opportunities for healthier choices. The severity of his illnesses was accentuated later by his primary care physician (PCP), who noted that the patient was unable to decrease his susceptibility to developing diabetes mellitus (DM) due to this intervention. However, I provided the patient with resources regarding the possibilities to overcome this barrier through diet and exercise. By week 8, his cravings for unhealthy food became rare, as he avoided any meals that caused his blood sugar to spike. Week 9 has shown that the patient will remain on track to a healthy life, as his exercise routine became an hour of aerobics 5-6 times a week and 3-4 days lifting weights.
Outcomes of the Case Study
After ten weeks of the ongoing intervention into the patient’s life, there were significant positive changes. It is possible to conclude that the patient’s behavior will gradually improve his overall health. In comparison, his final A1c level was 5.7 mg/dl, while at the beginning of this 10-week case study, it was 6 mg/ml. Moreover, his weight went down by 15 lbs, bringing his BMI to 29 instead of the initial 31.3. The resting heart rate also improved, dropping from 83 down to 74. These perceived benefits will continue to contribute to the patient’s willingness to remain on track to complete behavioral adjustment. This case demonstrates the impact of an intervention based on the application of HBM and the education of the patient on healthy choices. The core concepts of HBM allow healthcare professionals to act upon perceived health-related factors to stimulate meaningful action and promote healthy decisions.
References
Frenn, M., & Whitehead, D. K. (2021). Health promotion: Translating evidence to practice. F.A. Davis.
Health belief model. (n.d.). Wikipedia.
The health belief model. (n.d.). Boston University Medical Campus.
Olson, K., Bond, D., & Wing, R. R. (2017). Behavioral approaches to the treatment of obesity.Rhode Island Medical Journal, 100(3), 21-24.
Shao, C., Wang, J., Liu, J., Tian, F., & Li, H. (2018). Effect of a health belief model-based education program on patients’ belief, physical activity, and serum uric acid: A randomized controlled trial.Patient Preference and Adherence, 12, 1239-1245.
Villar, O. A., Montañez-Alvarado, P., Gutiérrez-Vega, M., Carrillo-Saucedo, I. C., Gurrola-Peña, G. M., Ruvalcaba-Romero, N. A., García-Sánchez, M. D., & Ochoa-Alcaraz, S. G. (2017). Factor structure and internal reliability of an exercise health belief model scale in a Mexican population.BMC Public Health, 17(1).