PHE 340 Module 2 Health Belief Model Short Paper Example

It Won't Happen Two Miles From Home: The Health Belief Model and Seat Belt Use in the Nebraska Sandhills

[Student Name]

Southern New Hampshire University

PHE 340: Social and Behavioral Health

Module Two Short Paper

[Instructor Name]

[Date]

The organization, setting and figures below are a composite written as a model document. No real employer, client, colleague or patient is described.

It Won't Happen Two Miles From Home: The Health Belief Model and Seat Belt Use in the Nebraska Sandhills

The health belief model is one of the oldest and most widely used theories in public health. Its premise is that someone acts to protect their health once the threat feels personal and grave, the step looks worthwhile and the obstacles look surmountable, with a prompt to act and enough confidence to follow through. This paper applies the model to seat belt use in a composite county in Nebraska's Sandhills, where many drivers do not buckle up on the short trips that make up most of their driving. It draws on interviews the student conducted with twelve local drivers, ten men and two women aged 19 to 67, recruited at the grain elevator, the feed store and a 4-H event.

The Model

Looking across ten years of studies that used the model, Janz and Becker (1984) found that perceived barriers were the strongest single predictor across many behaviors, followed by perceived susceptibility, while perceived severity was a weaker predictor. That pattern matters for this analysis because it suggests where interventions are most likely to make a difference. The model treats behavior as the product of beliefs, which makes it useful for designing messages but limited in explaining habits, norms and laws, a limit this paper returns to at the end.

Perceived Susceptibility

Most of the drivers interviewed did not feel at risk on the trips they make most often. A 54-year-old rancher said, I've driven these roads forty years; I know every turn. Several said crashes happen on the highway, not on the gravel between pastures. Two younger drivers said they buckle on the interstate but not around the ranch. This belief is understandable, because most trips are short and slow, but it is not supported by the pattern of local deaths, which more often involve single-vehicle rollovers on rural roads. Strine et al. (2010) found that the most rural residents nationally were least likely to always wear belts, which suggests that this sense of safety close to home is widespread. Susceptibility is the weakest belief in this audience.

Perceived Severity

Severity, by contrast, is well understood. Every driver could name someone hurt or killed in a crash, and several described rollovers in detail. A woman in her thirties said, If you roll out here, you're thrown, and it's a long way to a hospital. The seriousness of a crash is not in doubt; drivers simply do not connect it to their own short trips.

Perceived Benefits

All twelve agreed that belts save lives in highway crashes. Fewer were sure about low-speed gravel crashes. Three believed that being thrown clear was safer than being trapped in a rolling truck, a belief repeated in rural areas but contradicted by crash research, which shows ejection is among the deadliest outcomes. Benefits are accepted in general but doubted in the specific situations that matter here.

Perceived Barriers

Barriers were the most common topic. Drivers described getting in and out of the truck to open gates, as often as ten times on a short run, and said buckling and unbuckling each time was a nuisance. Others mentioned heavy coats in winter, belts that are stiff or dirty in old work trucks and dogs or tools on the seat. Several said the belt chime in newer trucks was so irritating that they had it disabled. Janz and Becker (1984) found barriers to be the strongest predictor across studies, and in this audience they are concrete and constant.

Cues to Action and Self-Efficacy

Cues to buckle were rare. Few drivers had seen a belt message recently, the chime had been disabled in some trucks and nobody in the cab reminded them. The main cue was driving onto the highway, which prompted most to buckle. Self-efficacy was high: everyone was capable of buckling. The question was not whether they could, but whether it seemed worth doing at every gate.

Differences Within the Audience

The twelve drivers were not all alike. The two youngest, both under 25, buckled more often than the older ranchers and said their parents had insisted when they learned to drive, but they also described riding in the back of pickups and unbuckling when friends did. Older ranchers had the lowest sense of susceptibility and the strongest attachment to their own driving skill. The two women interviewed buckled on most trips and described doing so mainly for their children's sake, a benefit the men did not mention. These differences suggest that one message will not fit everyone: young drivers may respond to peer examples, older ranchers to stories of people like themselves and parents to the example they set for children riding with them. A larger survey in Project One will test whether these patterns hold across the county.

What the Analysis Suggests

Applying the model points to two targets. First, susceptibility: drivers need to believe that short, familiar trips carry real risk, perhaps through local stories of rollovers on gravel told by people they trust. Second, barriers: anything that makes buckling easier on gate-heavy trips would help, from cleaner belts to habits like buckling once on the road and leaving the truck running while a passenger handles gates. Severity and self-efficacy are already strong and need little attention. The model also has limits here. It does not account for the crew norms described in Module One or for the effect of laws. Dinh-Zarr et al. (2001) found that belt laws and enforcement produce strong effects on belt use, which no change in beliefs alone is likely to match. The health belief model can shape messages, but it should be part of a larger plan.

Conclusion

The health belief model fits this audience well enough to be useful. It shows that Sandhills drivers already believe crashes are serious and know how to buckle, but do not feel at risk close to home and find buckling at every gate a nuisance. Those two beliefs are where messages and practical changes should focus.

References

Dinh-Zarr, T. B., Sleet, D. A., Shults, R. A., Zaza, S., Elder, R. W., Nichols, J. L., Thompson, R. S., & Sosin, D. M. (2001). Reviews of evidence regarding interventions to increase the use of safety belts. American Journal of Preventive Medicine, 21(4, Suppl.), 48-65. https://doi.org/10.1016/S0749-3797(01)00378-6

Janz, N. K., & Becker, M. H. (1984). The health belief model: A decade later. Health Education Quarterly, 11(1), 1-47. https://doi.org/10.1177/109019818401100101

Strine, T. W., Beck, L. F., Bolen, J., Okoro, C., Dhingra, S., & Balluz, L. (2010). Geographic and sociodemographic variation in self-reported seat belt use in the United States. Accident Analysis and Prevention, 42(4), 1066-1071. https://doi.org/10.1016/j.aap.2009.12.014