Illness attributions and the health belief model.

This paper proposes an attributional approach to the traditional Health Belief Model (HBM). It is argued that this approach has two purposes: (1) health beliefs might themselves be determined by attribution and (2) the prediction of health behavior might be significantly improved by combining health beliefs with illness attributions. The theoretical framework for this approach is adapted from models of causal attribution and relevant literature on illness attributions is reviewed. Two empirical studies are described testing the plausibility of an attributional approach to health behavior. A preliminary study investigates the relationship between health beliefs and illness attributions of heart patients. Health beliefs were found to be significantly related to causal explanations of heart disease. The main study is a prospective investigation of the impact of attributions and health beliefs on health behavior--in this case attendance at screening for high blood pressure. Discriminant analysis revealed a combination of health beliefs and attributions of high blood pressure that produced a highly significant prediction of the decision to participate in the screening. The final discussion is devoted to the theoretical and practical implications of an attributional approach for health and medical education, particularly within the medical consultation.