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5УДК 316.6
Deriugina A. student
3nd year, Faculty of Sociology St Petersburg State University Russia, St Petersburg ANALYZE OF THE ARTICLE: EVALUATING THE EFFECTIVENESS OF HEALTH BELIEF MODEL INTERVENTIONS IN IMPROVING ADHEARENCE:
A SYSTEMATIC REVIEW WRITTEN BY Annotation: The article is an over-view of the work presented by Christina Jane Jones, Helen Smith & Carrie Llewellyn. The idea of this paper is to analyze ideas about Health Belief Model, discuss in which way researches of previous papers have done their works and what are the pluses and downsides of them. What impact Health Belief Model has on our life and is it still actual nowadays. Keywords: Health Belief Model, health, behavior, effectiveness
Christina Jane Jones, Helen Smith & Carrie Llewellyn As I understood the main study idea of the paper of Christina Jane Jones, Helen Smith & Carrie Llewellyn was to find and analyze different researches connected with effectiveness of Health Belief Model that were conducted in the period spanned in four decades: three studies were published in the 1980s, seven in the 1990s, three in the 2000s and five in the 2010s. While reading this research review, I caught up for myself several goals. First of all, as I said, it was to find papers that would fit the interest of researchers, then to analyze them using one criteria and compare them between each other, make sure that researches seems to be objective and impersonal and understand what results were reached by the end of them and eventually to give their own opinion about these papers with some recommendations for further works.
Firstly, it is important to mention what actually is a Health Belief Model itself. In the 1950s, the Health Belief Model was designed to predict health-promoting behaviors, such as uptake of screening programmes, for the US public health services. Subsequently, the HBM has been used to examine sick role behaviors such as adherence to medical advice. Important to mention a study by the World Health Organization which found out that only 50% of patients in developed countries adhere to their treatment guidelines (Sabate', 2003) and that seems to be a problematic issue.
To date, there has been no systematic review of the evidence to support the use of the HBM as the basis for the design of health-promoting interventions. Using a systematic approach, studies which have employed the HBM as the theoretical basis for design of an intervention to improve adherence to health behaviors were reviewed for the impact and success of their intervention.
Researches had special selection strategy. The took only studies that fulfilled six criteria:
1. interventional in design
2. intervention aimed at improving adherence to medical regime rather than physical activity/healthy eating
3. adherence measured as a behavioral outcome
4. intervention designed to address all/some of the constructs derived from the HBM
5. no other additional established psychological model informed the intervention
6. published in English
In general, only 18 out of 541 works faced all of the criteria and therefore were analyzed. What is more all of them differ in countries, genders, timelines, goals, narrow research topics, age groups and so on. In order to make a more accessible and complete analysis all research criteria were reduced to one indicator and translated into the scale made by the authors of the article as much as it was possible. During this paper researchers paid attention to every step of the previous works and gave their personal comments and recommendations about them which make sense.
The results of this paper are the following: from my point of view it is important to mention that hundreds of works were cancelled and were not analyzed in these researchers and that gives us food for thought (about 520 of them). With other 18 was made an in-depth review in order to find some tendencies and mistakes. One of the conclusions was made that among all methods of using health belief model one of the most popular forms of changing health treating behavior was providing information about health consequences to participants (16 studies). Also popular was the use of a prompt (8 written or verbal) to elicit a change in behavior (8 studies). These two techniques were often used together. Less popular was the use of instruction to teach a new behavior (such as self-examination) (5 studies). Less popular techniques used were clustered around social support (4 studies), comparison of outcomes (four studies), reward and threat (1 study) and regulation (1 study). The descriptions of the interventions were too limited to determine which technique best addressed which HBM construct. The three studies demonstrating the largest effect sizes used a combination of information about health consequences and prompts in their intervention as the behavior change techniques.
Talking about my personal opinion I was definitely impressed by the huge amount of work made by the researches. One of the downsides was also mentioned: he majority of studies failed to provide sufficient information to accurately assess risk of bias. The areas which were found to be particularly lacking in studies were the reporting of blinding and selective outcome reporting. Studies, published within the last decade, were more likely to demonstrate lower risk of bias than earlier studies.
To be honest, I haven't found any serious cons of this work but i would like to say that maybe it was not the best idea to take articles from really different decades because from my personal opinion 40 years is quite a big period. Also, this article itself seems to be a review to previous research works. However, I find it really important that at the end of the article authors give some recommendations and advices for future works that costs a lot in this way and always tried to be very
objective and in some controversial issues resorted to the opinion of second and sometimes even third experts.
Bibliography:
1. Christina Jane Jones, Helen Smith & Carrie Llewellyn "Evaluating the effectiveness of health belief model interventions in improving adherence: a systematic review"
