Synthetic application of health belief model and theory of reasoned action/planned behavior in studies related to health behaviors

Objective Health belief model and theory of reasoned action or theory of planned behavior have been used widely in studies of health behavior and combined to use in many studies to explain and predict definite health behaviors. A systematic review was conducted to analyze how two theories combined in the studies related to health behaviors, to explore general factors influencing different health behaviors, and so that to provide evidence for future health promotion and health education strategies. Methods Nine databases were searched using predetermined search strategies and 322 indexes were identified. Key information of included studies was extracted and the quality of each one was assessed according to Strobe Checklist and Cochrane Handbook for Systematic Reviews of Interventions. Results 40 papers including 37 studies were finally included in this review. 6 studies were of high quality, while others were of medium quality. Most studies were cross-sectional survey. Two theories were usually as the framework basis and used to develop research instruments in the included studies. Some researchers used behavioral intention as an outcome variable instead of actual behavior. Subjective norms, perceived susceptibility, and perceived behavior control were the most influencing factors for behavioral intention; perceived barriers, behavioral intention, and perceived behavior control were the most influencing factors for behavior. Conclusions There are some limitations need to avoid in the future studies synthetically using HBM and TRA/TPB. Improving individuals’ perceived susceptibility and subjective norms by extending the target population can serve as the common intervention to change health behaviors; further studies should identify individuals’ perceived barriers and control beliefs of specific behaviors, and make responding interventions. Key words: Health belief model; Theory of reasoned action; Theory of planned behavior; Health behavior; Systematic review