STAGE 4. Selecting the theoretical approach

What steps should be completed?

Step 1: Select the theoretical approach or approaches on which the intervention will be based


What are its bases?

This model (approach) explains the factors that predict behaviours related to health, mainly preventive behaviours. Its main elements are perceived susceptibility, perceived severity, perceived benefits and perceived barriers. The probability of performing a health behaviour is determined by the balance between the anticipated costs and benefits of the behaviour and by the perceived threat of the disease. Therefore, for a person to be at least minimally motivated to execute the behaviour, they must perceive that their health runs a certain risk and that the behaviour to reduce the risk has more advantages than disadvantages. The person must also feel capable (have a perception of self-efficacy) of carrying out the necessary behaviours to protect their health or prevent the potential problem.

The concurrence of a health threat being perceived and believing that it is possible to reduce that threat encourages certain behaviour patterns that preserve and improve health, and prevent risk situations and diseases.

Which determinants can be addressed?

Mainly personal determinants, in particular, different types of beliefs, such as the perceived threat (perception of a danger to personal health), perceived risk (perceived probability of risk of disease), severity (degree of importance that the person gives to the organic, psychological and social consequences of illness) or perceived benefits and costs (perceived positive or negative consequences of preventive behaviour). It also covers environmental determinants, such as the key to action: a set of external and internal signals that are activated or act as triggers of the perceived threat, such as media campaigns (external signal) or perception of symptoms (internal signal).

Practical implications

This model (approach) reveals the importance of evaluating and working on the perception of risk in relation to health problems as a behaviour predictor, for example, increasing perception through actions that raise awareness and allow realistic risk assessments. It also demonstrates the advisability of emphasising to people the potential benefits of certain health-promoting behaviours and helping them overcome perceived barriers, thereby enabling the behaviours. It is also a useful guide for planning health education actions, especially in the school setting.



Becker  MH & Mainan LA. (1975). Sociobehavioral determinants of compliance with health and medical care recommendations. Medical Care. 13: 10-24.

Rosentock IM. (1960). What research on motivation suggests for public health. American Journal of Public Health. 50: 295-302.