Health Belief Model-Based DSME
Concept Definition Application
Define population(s) at risk, risk levels; personalize risk
Perceived One's opinion of chances of based on a person's features or behavior; heighten
Susceptibility getting a condition perceived susceptibility if too low.
One's opinion of how serious a
Specify consequences of the risk and the condition:
Perceived Severity condition and its
DSME Day Three
One's belief in the efficacy of Define action to take; how, where, when; clarify the positive
Perceived Benefits the advised action to reduce effects to be expected.
risk or seriousness of impact DSME Day Two, Three and Four
One's opinion of the tangible Identify and reduce barriers through reassurance,
Perceived Barriers and psychological costs of the incentives, assistance.
advised action DSME Day Four
Provide how-to information, promote awareness,
Strategies to activate
Cues to Action reminders.
DSME Day Four
Confidence in one's ability to Provide training, guidance in performing action.
take action DSME Day Four
Diabetes Self-Management Education
Curriculum Development Based on Health Belief Model (HBM)
When incorporating HBM into a Health Education curriculum, use the following checklist to help
you design your class.
Checklist for Educators Implementation Ideas
(applicable HBM concepts appear in parentheses)
1. Do you include an
Show attendees videos which have characters that they
activity that increases
can relate to the same diabetes.
attendees' perception of
their own vulnerability to
the condition? Ask them to complete confidential personal risk
Present recent statistics of patients with similar
demographic background with diabetes.
Gave them the URL of websites such as ADA, Joslin and
International Diabetes Center that teaches them diabetes.
Invite guest speakers of the similar demographic to share
their experiences with the condition.
2. Do you assess
Generate discussion about whether or not students feel
attendeess' perception of
they could get the condition.
their own vulnerability to
Ask attendees to anonymously write down on an index
card whether they believe they could get the condition and
then collect the cards.
Analyze the results of their personal risk assessments
(under #1 above) and generate a discussion of their
3. Do you include activities
Show photos of people suffering with diabetes
that teach the seriousness
of the condition and its
Share case studies of people experiencing difficult
consequences of the condition.
Lead a visualization activities having attendees imagine
they have the one of the complications and are dealing with
Tell the attendees to imagine having the condition and the
complication, and ask them to each write a letter to their
best friend explaining what happened and how it feels to
have the condition.
Share compelling statistics of negative consequences of
Invite a guest speaker with the condition to explain what
he/she has had to cope with under the circumstances.
Show a video showing people with the condition talking
about how their lives have changed.
Ask students to brainstorm at least 20 ways the condition
would change their lives.
4. Do you assess students'
Ask the attendees to answer questions about how serious
perception of the severity
the condition is, or how much they want to avoid it (e.g., on
of the condition?
a scale of 1 - 10).
Ask students to write down on index cards whether or not
they believe the condition is serious, with their reasons,
and collect the cards.
5. Do you clearly present
Present the desired action in various ways — explain it,
the desired action to take
post it, distribute it in print, and reinforce it throughout the
to avoid the condition?
Model how to take the action in front of the group.
Be sure attendees have all the information they need to
take the action (e.g., when to test blood sugar, how to
problem solve glucose monitor error readings, what tests
need to be ordered and when before seeing their provider,
when to see their provider, how to count carbohydrate on
and how to read food labels, etc.)
Clearly present the benefits of the recommended action
using reliable resources (e.g. information from ADA and
6. Do you assess whether
Generate discussion among attendees about whether they
the attendees believe the
really think that the action will prevent the condition
action will benefit them by
(include the reasoning behind each action).
preventing the condition?
Have them in groups and discuss whether they believe that
the desired action will prevent the condition. Have each
group report back to the class, listing the different reasons
behind the identified actions.
Invite attendees to voice any doubts they may have about
the benefits of the desired action and then gently help them
see all sides of the issue.
Have a guest diabetic who experiences benefits from using
the action address the class. Alternatively, a video may be
7. Do you help youth
Have the group brainstorm all imagined barriers to taking
identify their personal
action. Then ask each of them to pick out one or two
barriers to action?
barriers that apply to them.
Give each attendees a list of common barriers to taking
action. Ask them to circle the ones that apply to them.
Show a video or present a case study in which youth can
recognize barriers experienced by someone else. Ask them
if they can relate.
8. Do you support patients
Consider whether perceived barriers can be reduced by
with diabetes in reducing or
helping diabetics obtain additional information, use more
eliminating barriers (or
time for skill-building, or build their own confidence taking
perception of barriers) to
Ask each to role-play advising a younger sibling or friend
who is faced with the same barriers to taking action.
Brainstorm with large group strategies to overcome each
If subject matter is not too sensitive, have them work in
small groups to brainstorm ways to reduce stated barriers.
9. Do you provide patients
Provide patients with incentive items (e.g., pencils, pens)
with cues to action?
which contain visual reminders of the message or
Hang posters with the action messages in your setting.
Encourage patient to write newsletter articles or take on art
projects to creatively express the action message.
Organize community-wide events showcasing the action
Encourage patients to discuss the recommended action
with their significant others.
(Cues to Action)
10. Do you assess Educators should determine their attendees’ level of
whether patients feel confidence in using a skill or taking an action by:
confident that they can
take the recommended Observing their skill practice;
Promoting discussion with them about their practice
experience, which may bring up doubts or
perceived barriers to confidently using the skill;
Positively reinforcing desired behaviors and steps to
the desired behaviors.
Conducting a brief anonymous survey after the skill
building session to elicit questions or concerns that