McWhirter Jennifer E, Hoffman-Goetz Laurie
a School of Public Health and Health Systems , University of Waterloo , Waterloo , Ontario , Canada.
J Health Commun. 2016;21(4):424-38. doi: 10.1080/10810730.2015.1095819. Epub 2016 Mar 3.
The health belief model (HBM) has been widely used to inform health education, social marketing, and health communication campaigns. Although the HBM can explain and predict an individual's willingness to engage in positive health behaviors, its application to, and penetration of the underlying constructs into, mass media content has not been well characterized. We examined 574 articles and 905 images about skin cancer and tanning risks, behaviors, and screening from 20 U.S. women's and men's magazines (2000-2012) for the presence of HBM constructs: perceived susceptibility, perceived severity, perceived benefits, perceived barriers, self-efficacy, and cues to action. Susceptibility (48.1%) and severity (60.3%) information was common in text. Perceived benefits (36.4%) and barriers (41.5%) to prevention of skin cancer were fairly equally mentioned in articles. Self-efficacy (48.4%) focused on sunscreen use. There was little emphasis on HBM constructs related to early detection. Few explicit cues to action about skin cancer appeared in text (12.0%) or images (0.1%). HBM constructs were present to a significantly greater extent in text versus images (e.g., severity, 60.3% vs. 11.3%, respectively, χ(2) = 399.51, p < .0001; benefits prevention, 36.4% vs. 8.0%, respectively, χ(2) = 184.80, p < .0001), suggesting that readers are not visually messaged in ways that would effectively promote skin cancer prevention and early detection behaviors.
健康信念模型（HBM）已被广泛应用于健康教育、社会营销和健康传播活动。尽管HBM能够解释和预测个体采取积极健康行为的意愿，但其在大众媒体内容中的应用以及潜在结构的渗透情况尚未得到充分描述。我们研究了2000年至2012年期间美国20种男女杂志上关于皮肤癌和晒黑风险、行为及筛查的574篇文章和905张图片，以确定是否存在HBM结构：感知易感性、感知严重性、感知益处、感知障碍、自我效能感和行动线索。易感性（48.1%）和严重性（60.3%）信息在文本中较为常见。文章中对预防皮肤癌的感知益处（36.4%）和障碍（41.5%）提及程度相当。自我效能感（48.4%）主要集中在使用防晒霜方面。与早期检测相关的HBM结构很少被强调。关于皮肤癌的明确行动线索在文本（12.0%）或图片（0.1%）中出现较少。与图片相比，HBM结构在文本中的呈现程度显著更高（例如，严重性分别为60.3%和11.3%，χ(2)=399.51，p<.0001；预防益处分别为36.4%和8.0%，χ(2)=184.80，p<.0001），这表明读者没有接收到能够有效促进皮肤癌预防和早期检测行为的视觉信息。
