Using behavior change models to ensure a more holistic assessment of health conditions

Dec 18, 2025

ASCO GU 2025

Behavior Change models condense many years of research on the influences shaping our actions.  In healthcare market research, there continues to be significant focus on COM-B, given its wide applicability. We should not, however, overlook the potential contribution of other models. For example, the Health Belief Model (Rosenstock, 1974, updated by Becker, 1977) and the Socioecological Model (Bronfenner, 1979) each provide important perspectives on the influences on health behaviors.

The Health Belief Model focuses on patients’ inner beliefs, triggers, and motivations, while the Socioecological Model focuses on the external and societal influences. Combining these different perspectives allows us to understand patient health behaviors more holistically. Providing a stronger basis to understand the patient experience – and to design behavior change interventions that are likely to be effective.

The Health Belief Model dives deep into the personal factors supporting health behaviors

As shown in the diagram below, the Health Belief Model focuses on three core strands:  

  1. Patient beliefs about their health risks
  2. Patient beliefs about treatments (or other health behaviors)
  3. The factors impacting their health behaviors

Each of these strands has two elements, which, together, provide a comprehensive understanding of factors guiding patient health behaviors and the opportunities to change them.

Diagram 1 – the Health Belief Model

As an example, we could consider the factors that might influence patient willingness to use a chronic weight management treatment.

Criteria Example considerations
Perceived susceptibility
  • Do they feel at risk of further weight gain? 
  • What have been the experiences of weight gain amongst their family and peers?
Perceived severity
  • What do they see as the personal consequences of weight gain?
  • Do they have relatives with T2D or cardiovascular disease?  
    • Do they see themselves as being at risk of these conditions?
    • Do they link these conditions to weight gain/obesity?
  • Do they experience joint pain or mobility issues due to obesity? 
Perceived benefit
  • What do they expect to be able to experience if they achieve weight management?
  • Do they have previous experiences of weight management, and does this influence their expectations?
Perceived barriers
  • What stops them from using a weight management approach?  
  • What are their personal, social, organizational, and financial constraints?
Cues to action
  • What would make them want to seek weight management?   
Self-efficacy
  • How do they see their own ability to make changes in their behavior?  
    • Do they have the skills and support they need?
  • Do they have previous experience of successful change?  
    • What helped or hindered them in that situation? 

The Socioecological Model: the external influences shaping health behaviors

The Socioecological Model focuses on the societal factors guiding behaviors. It helps us recognize both the variety of external influences and their respective strengths. Some (such as government and legal restrictions) have significant influence but may not be experienced directly – patients may be more aware of family members, friends, or social media influencers. Given the importance of societal influences on health and treatment decisions, for example, as we found in our recent self-funded study: The Power of Words: In sickness and in health, this model gives a framework in which external influences can be understood.

Diagram 2 – the Socioecological Model

Again, using chronic weight management as an example, we can see the model leads us to focus on different but complementary factors in our assessment:

Criteria Example considerations
Individual
  • Understanding of obesity and the causes of weight gain 
  • Personal preferences and food preparation skills
Interpersonal
  • Family food buying behaviors, family meal patterns 
  • Role of food in family activities
  • Impact of family members’ food preferences
Community
  • Peer group food culture (recipes, cooking styles)
  • Peer group attitudes to weight and appearance
  • Local availability of fresh and ultra-processed foods 
Organizational 
  • Exposure to advertising and information from food industry sources 
  • Access to guidance and advice from HCPs
Governmental
  • Food regulation, subsidies, and taxation

This summary of these two behavioral models shows how they could shape a deep understanding of the factors influencing weight and weight management. The Health Belief Model and Socioecological Model – both relatively simple to understand – remind us to consider a wide range of powerful influences on health behaviors. Taken together, they provide a comprehensive framework for assessing the factors affecting health behaviors and give our clients a solid foundation to assess possible behavior change options.

Chat to our Beyond Behavior team about how these two models could help you unearth a powerful range of influences.

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