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The health belief model matters because it explains why someone with full knowledge of a health risk still might not act on it. It proposes that a person is more likely to take a health action, such as attending screening, when four beliefs line up: susceptibility, severity, benefits, and barriers. For example, imagine a man who knows smoking causes lung cancer, high perceived severity, but does not believe it will happen to him, low perceived susceptibility: despite the knowledge, he is unlikely to quit. In practice, perceived barriers, such as cost, embarrassment, or inconvenience, are often the most changeable of the four beliefs.

The health belief model was developed by Rosenstock and Becker to explain uptake of preventive health behaviours, such as screening and vaccination. Its four core beliefs, perceived susceptibility, severity, benefits, and barriers, combine with a cue to action, an external or internal trigger such as a symptom, a leaflet, or a friend's diagnosis, to prompt behaviour. A later version added perceived self-efficacy (confidence one can actually carry out the action) as a fifth component. Picture a woman who believes she is at risk of cervical cancer (susceptibility), that it would be serious (severity), and that a smear test would help (benefit). A reminder letter then acts as the cue to action that finally prompts her to book. In practice, campaigns that only raise perceived susceptibility, e.g. shock statistics, without also lowering perceived barriers often fail to change behaviour.

• A construct describing a person's confidence in their own ability to carry out the required behaviour was added to the health belief model later. What is that construct?
• The health belief model was originally developed in the 1950s to explain a specific public health failure. Which problem prompted its development?
• A woman knows she is at high risk of diabetes and believes the condition is serious, yet still does not attend screening. Which element is the model's likeliest explanation?
• A critic notes that the health belief model treats people as weighing costs and benefits rationally. Which limitation does this assumption create?

• Theory of planned behaviour, adds subjective norm and intention as the direct predictor, unlike the health belief model's four standalone beliefs.
• Stages of change (transtheoretical model), describes discrete readiness stages, whereas the health belief model describes static beliefs rather than a stepwise process.
• Self-efficacy, one specific added belief in later versions, rather than the model's original four core constructs.
• Locus of control, a general attributional trait, unlike the health belief model's health-specific, situational beliefs.

• That construct concerns an external trigger rather than capability.
• That programme was not the original stimulus for the model.
• That construct was among the original four in the model.
• Childhood obesity postdates the model's development.
• She is described as recognising her high risk.

• Name the learning, social or research principle being tested before reading the options.
• Identify the antecedent, behaviour, consequence or cognitive process in the vignette.
• Compare the direction of effect with the nearest competing principle.
• Apply the same rule to a new example to confirm that the answer transfers.