What it shows
The health belief model, following its basic elements as drawn by Janz and Becker (1984). Modifying factors act on perceived susceptibility and severity, on perceived threat and on the weighing of benefits against barriers; susceptibility and severity make up perceived threat, which cues to action also feed; threat and the benefits-against-barriers group lead to the likelihood of taking the health action.
Self-efficacy, added to the model in 1988 by Rosenstock, Strecher and Becker, is drawn as a further input in a dashed outline, and health motivation, which the same paper lists as a component of the model, as another. Every box carries the same example: getting a flu vaccine.
How to read it
Follow the arrows left to right: modifying factors, the perceptions, perceived threat, then the likelihood of action.
Cues to action, such as a reminder from the doctor, feed perceived threat.
Benefits and barriers share one box with one arrow, because they are weighed against each other: the vaccine protects, but there is the cost or the fear the shot will hurt.
The dashed outline marks self-efficacy as the 1988 addition.
The constructs
- Modifying factors: demographic, psychosocial and structural variables. Example: age, personality, knowledge of the flu.
- Perceived susceptibility: thinks they could catch the flu. Perceived severity: thinks the flu could be serious.
- Perceived threat: sees the flu as a real threat. Cues to action: a reminder from the doctor.
- Perceived benefits: believes the vaccine protects. Perceived barriers: the cost, or fear the shot will hurt.
- Self-efficacy (added in 1988): confident they can get the shot. Health motivation: cares about staying well. Outcome: gets the flu vaccine.
Ways to use it in teaching
Students swap the flu vaccine for another health behavior, such as cancer screening, and rewrite every orange line.
Turn each box into a survey item and discuss which constructs are hardest to measure (Janz and Becker note that few studies have even tried to measure cues to action).
Compare it with the theory of planned behavior: which boxes map onto attitude, subjective norm and perceived behavioral control?
To see how a theory like this becomes the framework of a study, read our theoretical framework examples.
Sources
- Health belief model. (n.d.). In Wikipedia. Retrieved October 19, 2026, from https://en.wikipedia.org/wiki/Health_belief_model
- Janz, N. K., & Becker, M. H. (1984). The health belief model: A decade later. Health Education Quarterly, 11(1), 1–47. https://doi.org/10.1177/109019818401100101
- Rosenstock, I. M., Strecher, V. J., & Becker, M. H. (1988). Social learning theory and the health belief model. Health Education Quarterly, 15(2), 175–183. https://doi.org/10.1177/109019818801500203
