Health belief model and reversal theory: a comparative analysis

BACKGROUND: In recent years, an increasing number of nurses have demonstrated interest in health behaviour change interventions and research. Despite this heightened enthusiasm, there appears to have been less interest in exploring new and emerging health behaviour change theories. AIM: The goal of this work is to assist clinicians and researchers to make more informed choices about the use of the Health Belief Model and Reversal Theory in their practice settings and research projects. METHOD: Primary sources were analysed using qualitative data analysis methods in order to compare and contrast the two models. Four comparative categories provided the structure for analysis: origins of models, ways of knowing and behaving, role of health care providers in behaviour change, and desired outcomes. RESULTS: Based, in part, on their historical origins, the Health Belief Model and Reversal Theory offer differing tenets regarding how individuals perceive, understand, and behave. According to Reversal Theory, ways of knowing and behaving are dependent upon innate physiological factors and subjectively structured perceptions. In contrast, the Health Belief Model suggests that health-related behaviours are largely attributable to cognitive decision-making processes. As such, health care providers are directed to approach health behaviour change in different ways. CONCLUSIONS: Although the Health Belief Model has been widely implemented, Reversal Theory may offer a more comprehensive framework for health behaviour change interventions and research. Clinicians and researchers are urged to learn more about this theory and how it may apply to their areas of practice and research.