susceptibility and severity. With relatively little acceptance of
susceptibility to or severity of a disease, rather intense stimuli would
be needed to trigger a response. On the other hand, with relatively
high levels of perceived susceptibility and severity even slight stimuli
may be adequate. For example, other things being equal, the person
who barely accepts his susceptibility to tuberculosis will be unlikely to
check upon his health until he experiences rather intense cues. On the
other hand, the person who readily accepts his constant susceptibility
to the disease may be spurred into action by the mere sight of a mobile
x-ray unit or a relevant poster.
Unfortunately, the settings for most of the research on the Model.
have precluded obtaining an adequate measure of the role of cues.
Since the kinds of cues that have been hypothesized may be quite
fleeting and of little intrinsic significance (e.g., a casual view of a
poster urging chest x-ray), they may easily be forgotten with the
passage of time. An interview taken months or years later could not
adequately identify the cues. Freidson has described the difficulties in
attempting to assess interpersonal influences as cues.8 Furthermore,
respondents who have taken a recommended action in the past will
probably be more likely to remember preceding events as relevant
than will respondents who were exposed to the same events but never
took the action. These problems make testing the role of cues most
difficult in any retrospective setting. A prospective design, perhaps a
panel study, will probably be required to assess properly how various
stimuli serve as cues to trigger action in an individual who is
psychologically ready to act
OTHER VARIABLES
In addition to the foregoing set of variables, early abortive attempts
were made to include as a motivational variable the concept of
salience of health and illness for the individual. The attempts were
abortive because no good operational measure of the concept of
salience could be devised; we came to believe that the perception of
susceptibility to and severity of a particular condition would itself be
motivating. It will subsequently be seen that the concept of motivation
was later reintroduced into the Mode1.e
Finally, our view of the role of demographic, socio-psychological,
and structural variables was that they served to condition both
individual perceptions and the perceived benefits of preventive actions,
a view we have not substantially modified. Figure 1 portrays the
original Health Belief Model.
It should be noted explicitly that the Model had a clearcut
avoidance orientation; diseases were regarded as negatively valent
regions to be avoided. This is in contrast to the view that some