MPH 505 Week 2 Health Belief Model Analysis Example

Health Belief Model Analysis: Why Men Who Fish From Small Open Boats Carry a Life Jacket but Rarely Wear One

Student Name

Chamberlain University

MPH 505: Public Health Communication and Behavioral Health Theories

Instructor Name

Month Day, Year

Health Belief Model Analysis: Why Men Who Fish From Small Open Boats Carry a Life Jacket but Rarely Wear One

The Behavior and the Population

This analysis applies the health belief model to one behavior: wearing a life jacket at all times while underway or drifting in a small open motorboat. The population is men aged 40 to 74 who fish from their own boats, under 21 feet, on the two reservoirs of Pruitt County, a composite rural county. In a composite count our program ran at the main ramps over four spring weekends in 2026, 7% of adult men leaving in boats of this size wore a life jacket, although nearly all had one aboard. The gap between carrying and wearing is the behavior the analysis has to explain.

The stakes are clear in national figures. Drowning accounted for about three quarters of recreational boating deaths in 2024 where the cause was known, and among drowning victims whose life jacket use was recorded, 87% were not wearing one (U.S. Coast Guard, 2025). Fishing was the activity at the time of 178 of the year's 556 deaths, close to one in three.

Why One Model, and Why This One

In the health belief model, action becomes likelier as four judgments line up: that one could be affected, that the harm would be grave, that the recommended step would cut the danger and that the step is worth what it costs, with cues to action and self-efficacy joining the model in later versions (Rosenstock, 1974; Champion & Skinner, 2008). I chose it because the anglers' own explanations for not wearing are mostly about risk and cost: they describe calm water, their swimming ability and discomfort. Those beliefs map directly onto the model's constructs. A model centered on social norms might fit a younger group better, and I return to that question at the end, but I hold to one model throughout this paper.

Perceived Susceptibility: Danger Is Tied to Weather

The model predicts that people who do not see themselves at risk will not act. Anglers in this group do see a risk, but they place it in bad weather. In focus groups with regular boat owners, most said they wore a life jacket only when conditions were poor, yet each could describe a dangerous moment that happened on a calm day (Quistberg et al., 2014). For our population, that means susceptibility is not low in general; it is low on exactly the mornings when they fish. Most falls overboard from a small boat happen while standing to cast, net a fish, pull an anchor or relieve oneself over the side, none of which depend on wind. A message that raises susceptibility has to move the risk from the weather to these ordinary actions.

Perceived Severity: Already High, and Not the Problem

Severity is the belief that the outcome would be serious. No one in this group doubts that drowning is serious. Raising severity further, with images of recovered bodies or grieving families, is likely to add little, because the belief is already near its ceiling. Carpenter's (2010) meta-analysis of the model found that severity was a weak predictor of behavior compared with benefits and barriers, which supports leaving it alone here.

Perceived Benefits: The Halving Is Not Widely Known

Benefits are beliefs about how well the action reduces the threat. Many experienced anglers believe that if they went in, they would grab the vest or swim to the boat. Evidence from Coast Guard records suggests that wearing a flotation device is associated with about half the risk of drowning death (Cummings et al., 2011). A vest under the seat does not deliver that benefit, because cold shock and the first minute in the water make reaching it unlikely. The benefit belief that needs strengthening is specific: wearing protects in a way that carrying does not.

Perceived Barriers: The Construct That Carries the Most Weight

Barriers are the costs a person expects from acting. For this group they are concrete. The bulky foam vests most anglers own are hot in summer and interfere with casting. Quistberg et al. (2014) also found that boaters saw a life jacket as a sign of inexperience or poor swimming, a barrier that is social rather than physical. Cost enters as well: an inflatable belt pack or suspender vest that removes most of the discomfort can cost as much as a new rod and reel, and the old foam vest already satisfies the carriage law.

In the model, barriers are often the strongest single predictor, and Carpenter (2010) found them the most consistent predictor across studies. For this population, the barriers account for most of the gap between carrying and wearing. The only behavior change reported by members of the Quistberg et al. (2014) focus groups came with a switch to inflatable devices, which reduces the physical barrier directly.

Table 1

Health Belief Model Constructs Applied to Life Jacket Wear Among Small-Boat Anglers

Note. Note. Population beliefs drawn from Quistberg et al. (2014) and composite county ramp conversations.

Cues to Action: The Ramp Is the Moment

Cues are prompts that trigger the behavior. For this group, nearly all the information about boating safety arrives at the wrong time: a pamphlet when the boat is registered, a reminder in a magazine in winter. The decision to wear or not is made in a few seconds at the ramp, while the boat is being backed in. The model predicts that a cue at that moment, such as a sign at eye level on the courtesy dock or a ramp attendant's question, would matter more than any message at home.

Self-Efficacy: Knowing How to Use an Inflatable

Self-efficacy refers to how sure someone feels about pulling off the requested step themselves. Wearing a foam vest takes no skill. Wearing an inflatable does: the angler has to choose between manual and automatic types, check the indicator that shows the cartridge is armed and know how to rearm it after use. Many men who would accept an inflatable are unsure about these steps and about whether it would really inflate. Self-efficacy is therefore low for the very device that removes the main barrier.

Where the Model Points and Where It Falls Short

The model points to barriers as the construct to work on first, with self-efficacy for inflatables and a well-timed cue close behind. It suggests leaving severity alone. Its limit is the social barrier: the belief that a life jacket marks a novice is about what other anglers think, and the health belief model treats it only as one cost among others. If the audience analysis in week 3 shows that the opinions of fishing partners and tournament anglers drive wearing more than personal risk beliefs, a model that gives norms their own place would explain more. For now, the health belief model gives a clear starting design: make wearing comfortable, teach the device and prompt at the ramp.

References

Carpenter, C. J. (2010). A meta-analysis of the effectiveness of health belief model variables in predicting behavior. Health Communication, 25(8), 661-669. https://doi.org/10.1080/10410236.2010.521906

Champion, V. L., & Skinner, C. S. (2008). The health belief model. In K. Glanz, B. K. Rimer, & K. Viswanath (Eds.), Health behavior and health education: Theory, research, and practice (4th ed., pp. 45-65). Jossey-Bass.

Cummings, P., Mueller, B. A., & Quan, L. (2011). Association between wearing a personal floatation device and death by drowning among recreational boaters: A matched cohort analysis of United States Coast Guard data. Injury Prevention, 17(3), 156-159. https://doi.org/10.1136/ip.2010.028688

Quistberg, D. A., Bennett, E., Quan, L., & Ebel, B. E. (2014). Low life jacket use among adult recreational boaters: A qualitative study of risk perception and behavior factors. Accident Analysis & Prevention, 62, 276-284. https://doi.org/10.1016/j.aap.2013.10.015

Rosenstock, I. M. (1974). Historical origins of the health belief model. Health Education Monographs, 2(4), 328-335. https://doi.org/10.1177/109019817400200403

U.S. Coast Guard. (2025). 2024 recreational boating statistics (COMDTPUB P16754.38). U.S. Department of Homeland Security. https://www.uscgboating.org/library/accident-statistics/Recreational-Boating-Statistics-2024.pdf