Toward a reconceptualization of communication cues to action in the Health Belief Model: HIV test counseling.

In the present study, the persuasive communication of HIV test counselors as cues to action in clients' decisions to practice safer sex was examined. Results indicated that contrary to expectations, hypothesized relationships inherent in the Health Belief Model (HBM) were not supported for the pre-HIV test survey. However, clients' perceptions of the severity of HIV/AIDS, their susceptibility to HIV/AIDS, the benefits of and barriers to practicing safer sex, and self-efficacy were correlated with compliance with safer-sex recommendations reported on the post-HIV test survey. Intriguing results revolved around communication cues to action. HIV test counseling session transcripts were content analyzed to determine the persuasive messages used by HIV test counselors that may have cued clients' health beliefs and safer-sex behaviors. The inductively-derived coding scheme emphasized the complexity of the interpersonal interaction taking place during counseling sessions. Results indicated that in some cases, use of certain persuasive strategies was related to short-term adoption of safer-sex recommendations. These findings bolstered the argument for a move toward reconceptualizing the HBM by centralizing communication cues to action.