An application of the health belief model toward educational diagnosis for VD education

A protocol is developed which allows the translation of the Health Belief Model (HBM) to practice in supplying empirical needs assessment data on which to build responsive and effective VD education. The HBM is recognized as among the most important theoretical formulations to explain health behavior available in the health education literature, although there has to date been no information as to how to bridge the gap between theory and practice for actual, specific, and detailed programmatic input. The present study describes a procedure for using the HBM as a tool enabling practitioners to isolate those beliefs that need to be addressed for a given population. Prior attempts at belief identification have been limited to the four major dimensions of the HBM (perceptions of susceptibility, seriousness, barriers, and benefits), often with a single item to address each gross dimension. Such efforts are incapable of determining discrete areas of beliefs subject to change through direct educational intervention. The conceptualization and development of an extended view of these dimensions to include numerous individual entities enables the practitioner to create a data base which overcomes this limitation. The development of the VD Health Belief Scale is detailed. Subscales were operationalized by developing standardized attitude scales comprised of Likert-type items requiring a response on a five-point scale of agreement; instrument refinement occurred at several stages; and selected items were screened through internal consistency item analysis. Resultant scales had acceptable reliability with alphas of .89, .66, .91, .86, and .84. A straightforward procedure is described to explain how the measure is used to develop appropriate needs assessment data using the HBM framework. Studies performed by the authors utilizing the procedure are presented to illustrate the application of the research protocol.