DO HEALTH BELIEFS PREDICT EXERCISE BEHAVIOR? EXPLORING THE CONSTRUCTS OF THE HEALTH BELIEF MODEL

Authors

  • Oloo Micky Olutende Department of Health Promotion and Sports Science, Masinde Muliro University of Science and Technology, Kakamega, Kenya
  • Maximilla N. Wanzala Dr., Department of Public Health, Masinde Muliro University of Science and Technology, Kakamega, Kenya
  • Edwin K. Wamukoya Department of Health Promotion and Sports Science, Masinde Muliro University of Science and Technology, Kakamega, Kenya

DOI:

https://doi.org/10.46827/ejpe.v0i0.2641

Keywords:

health belief model, structural equation modeling, physical activity evidence-based health promotion, non-communicable diseases, Kakamega, Kenya

Abstract

Objective: To determine if the tenets of the health belief model explain exercise behavior among residents of Kakamega county. Design: The study design was a cross-sectional analytical, that utilized quantitative methods. Setting: The study was conducted in Kakamega County, located in Western Kenya. Kakamega County has twelve sub-counties; Kakamega North (Malava), Kakamega Central (Lurambi), Kakamega South (Ikolomani), Kakamega East (Shinyalu) and Butere/Mumias. Sample: Simple random sampling was used to sample respondents. The formula that was used for calculating the sample size was Cochran with an attrition rate of 10% (n = 221). The sample consisted of participants from five sub-counties of Kakamega: Kakamega central (23.1%), Kakamega south (22.6%), Kakamega east (22.2%), Butere (17.5%) and Kakamega north (14.5%) Analysis: Data were analyzed through structural equation modeling (SEM). The alpha level for all the computations was considered significant at an α <0.05. Main outcome measures: Perceived susceptibility, modifying factors, perceived threat, perceived severity, cues to action and exercise behavior Results: The measurement model included six latent constructs measured by 22 indicator variables. All of the completely standardized parameter estimates obtained were significantly different from zero (t > 1.96) and loaded satisfactorily onto their corresponding latent variable. In the structural model, the estimation of this hypothesized structural model yielded an acceptable fit to the data, χ2 =1434.7, df = 680; χ2/df ratio =2.453(good), CFI = .822; RMSEA = .059, with 90% C.I. = .045 - .075, SRMR = .058. The perceived threat was a direct predictor of exercise behavior (β = .294, p < .001), the variable formed by perceived benefits minus perceived barriers was a direct predictor of exercise behavior (β = .017, p <.001). All variables explained 57% of the variance in exercise behavior. Conclusion: The health belief model provided useful insight in explaining exercise behavior of the respondents. Other theories should be investigated (e.g. Social Cognitive Theory, Health Action Process Approach) to determine which theory better explains behavior in the context and population of interest.

 

Article visualizations:

Hit counter

DOI

References

Animaw, W. & Seyoum, Y. (2017). Increasing prevalence of diabetes mellitus in a developing country and its related factors. PLoS ONE, 12(11), 1–11. https://doi.org/10.1371/journal.pone.0187670.

Asare, M. & Sharma, M. (2014). Establishing validity and reliability of a Health Belief Model and acculturation for measuring safe sex and sexual communication among African immigrants for protecting against HIV and AIDS. Journal of immigrant and refugee studies, 12, 3, 190-209.

Bloch, M. (2004). Benefits and Barriers to Motivation for Physical Exercise (Unpublished doctoral dissertation). University of Brighton, Brighton, England.

Bray, S. R., Brittain, D. R. & Gyurscik, N. C. (2004). Coping with barriers to vigorous physical activity during transition to university. Fam Community Health, 27(2):130-142.

Bridges, D. M., Guan, J., Keating, X. D. & Pinero, J. C. (2005). A meta-analysis of college students’ physical activity behaviours. J Amer Coll Health, 54(2):116-125.

Brown S. (2005). Measuring perceived benefits and perceived barriers for physical activity. Am J Health Behav, 29(2):107-116.

Champion, V. & Skinner, C. (2013). The health belief model.

Checkley, W., Ghannem, H., Irazola, V., Kimaiyo, S., Levitt, N. S., Miranda, J. J., … National Heart & Lung. (2014). Management of NCD in low- And middle-income countries. Global Heart, 9(4), 431–443. https://doi.org/10.1016/j.gheart.2014.11.003

Crombie, I., Irvine, L., Willams, B., McGinnis, A., Slane, P., Alder, E., & McMurdo, M. (2004). Why Older People Do Not Participate in Leisure Time Physical Activity: A Survey of Activity Levels, Beliefs and Deterrents. Age and Ageing, 33(3), 287-92.

Ding, D., Lawson, K. D., Kolbe-Alexander, T. L., Finkelstein, E. A., Katzmarzyk, P. T., van Mechelen, W. & Pratt, M. (2016). The economic burden of physical inactivity: a global analysis of major non-communicable diseases. The Lancet, 388(10051), 1311–1324.

Ferrini, R., Edelsteria, S. & Barrett-Connor, E. (1994). The Association between Health Beliefs and Health Behavior Change in Older Adults. Prevention Medicine,23(1).

Fiuza-Luces, C., Garatachea, N., Berger, N. A. & Lucia, A. (2013). Exercise is the real polypill. Physiology, 28(5), 330-358.

Godin, G. & Shephard, R.J. (1990). Use of attitude-behaviour models in exercise promotion. Sports Med, 10, 103-121.

Green, D. J., Spence, A., Halliwill, J. R., Cable, N. T. & Thijssen, D. H. (2011). Exercise and vascular adaptation in asymptomatic humans. Experimental physiology, 96 (2), 57–70

Grimstvedt, M., Der Ananian, C., Pasquariello, C. D., Masambia, F. M., Chevan, J., Haskvitz, E. M., …& Rogers, L. Q. (2013). The role of professional counseling associations in professional counseling practice in Kenya. Medicine and Science in Sports and Exercise, 77(3), 200. https://doi.org/10.2105/AJPH.69.6.591

Grossman, M. (1972). On the Concept of Health Capital and the Demand for Health. Journal of Political Economy, 80(2), 223-255.

Hayduk, L. A. (1996). LISREL Issues, Debates, and Strategies. The Johns Hopkins University Press, Baltimore and London.

Hu, L. T. & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Struct Equation Model, 6(1): 1–55

Jancey, J., Clarke, A., Howat, P., Maycock, B., & Lee, A. (2009). Perceptions of Physical Activity by Older Adults: A Qualitative Study. Health Education Journal, 68 (3), 196-206. doi: 10.1177/0017896909339531

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

Kelly, R., Zyzanski, S., & Alemagno, S. (1991). Prediction of Motivation and Behavior Change Following Health Promotions: Role of Health Beliefs, Social Support, and Self-Efficacy. Social Science Medicine,32(3).

Kenya Health Management Information system, 2012

Khan, K., Weiler, R. & Blair, S. N. (2011). Prescribing exercise in primary care. British Medical Journal, 343, 10–11

Kimmel, G. T., Haas, B. K. & Hermanns, M. (2014). The Role of Exercise in Cancer Treatment : Bridging the Gap. Current Sports Medicine Reports,13(4),246-52. doi: 10.1249/JSR.0000000000000068

Lee, I. M., Shiroma, E. J., Lobelo, F., Puska, P., Blair, S. N. & Katzmarzyk, P. T. (2012). Effect of physical inactivity on the world’s major non- communicable diseases. The Lancet, 380(9838), 219–229

Machio, P. M. (2012). “The Effect of Chronic Illness on Labor Market Outcomes in Kenya.” Center for the Study of Africa Economies. Oxford, UK. https://editorialexpress.com/cgi-bin/conference/download.cgi?db_name=CSAE2012&paper_id=502

Mattson, M. (1999). Toward a reconceptualization of communication cues to action in the health belief model: HIV test counselling. Commun Monogr, 66, 240–65. https://doi.org/10.1080/03637759909376476

Naci, H. & Ioannidis, J.P.A. (2013). Comparative effectiveness of exercise and drug interventions on mortality outcomes: meta-epidemiological study. BMJ, 347, f5577. https://doi.org/10.1136/bmj.f5577

Naomi, Y., Mika, O., Masumi, S., Kiko, A. & Sachiko, S. (2019). Do health beliefs, personality traits, and interpersonal concerns predict TB prevention behavior among Japanese adults. Plos one,1-10

Niven, N. (1994). Health Psychology: An Introduction for Nurses and Other Healthcare Professional. London, England: Churchill-Livingstone

Rosenstock, I. (1974). Historical Origins of the Health Belief Model. Health Education Monographs,2, 4.

Schmiege, S. J., Aiken, L. S., Sander, J. L., & Gerend, M. A. (2007). Osteoporosis prevention among young women: Psychosocial models of calcium consumption and weight-bearing exercise. Health Psychol, 26(5), 577-587.

Shaw, J. E., Sicree, R. A. & Zimmet, P. Z. (2010). Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Research and Clinical Practice, 87(1), 4–14

Soares-Miranda, L., Siscovick, D. S., Psaty, B. M., Longstreth, W. & Mozaffarian, D. (2016). PA and Risk of Coronary Heart Disease and Stroke in Older Adults: The Cardiovascular Health Study HHS Public Access. Circulation. January, 12(1332), 147–155. https://doi.org/10.1161/circulationaha.115.018323

Swift, C. S., Armstrong, J. E., Beerman, K. A., Campbell, R. K. & Pond-Smith, D. (1995). Attitudes and beliefs about exercise among persons with non-insulin-dependent diabetes. Diabetes Educ, 21(6), 533-540.

Tero, P., Samppa, T., Ari, H. & Urho, M. K. (2017). Exercise therapy for functional capacity in chronic diseases: an overview of meta-analyses of randomized controlled trials. British Journal of Sports Medicine. https://doi:10.1136/bjsports-2016-097132

Thent, Z. C., Das, S. & Henry, L. J. (2013). Role of exercise in the management of diabetes mellitus: The global scenario. PLoS ONE, 8(11), 1–8. https://doi.org/10.1371/journal.pone.0080436

Vermandere, H., Stam, M. A., Naanyu, V., Michielsen, K., Degomme, O. & Oort, F. (2016). Uptake of human papilloma virus vaccine in Kenya: testing the health belief model through pathway modelling on cohort data. Global Health, 12, 17,211-217.

Villar, O. A. E., Priscila, M. M., Marisela, G. V., Irene, C. C. S., Gloria, M. G. P., Norma A. R. R., María, D. G. S. & Sergio G. O. A. (2017). Factor structure and internal reliability of an exercise health belief model scale in a Mexican population. BMC Public Health, 17, 229. DOI.10.1186/s12889-017-4150-x

Volk, J. E. & Koopman, C. (2001). Factors associated with condom use in Kenya: a test of the health belief model. AIDS Education Prevention, 13, 6, 495-508.

Von Ah, D., Ebert, S., Ngamvitroj, A., Park, N. & Kang, D. (2003). Predictors of health behaviours in college students. J Adv Nurs, 48(5):463-474.

Wiklund, P. (2016). The role of PA and exercise in obesity and weight management: Time for critical appraisal. Journal of Sport and Health Science, 5(2), 151–154. https://doi.org/10.1016/j.jshs.2016.04.001

World Health Organization. (2017). Preventing Noncommunicable Diseases (NCDs) Reducing Environmental Risk Factors. Retrieved from http://apps.who.int/iris/bitstream/10665/258796/1/WHO-FWC-EPE-17.01-eng.pdf?ua=1

Downloads

Published

2019-09-19

Issue

Vol 5, No 12 (2019)

Section

Articles

License

Authors who publish with this journal agree to the following terms:

 

  1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.

 

  1. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.

 

  1. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).