A Systematic Review of the Health Belief Model (HBM): Theoretical Evolution, Application Domains, Limitations and Future Research Directions

Abstract

The Health Belief Model (HBM) is one of the most influential cognitive psychological frameworks for predicting and intervening in human health behaviors. Originating from tuberculosis screening research in the 1950s, the HBM has undergone multiple theoretical revisions, most notably the addition of self-efficacy in the 1980s, gradually forming a complete analytical system covering perceived threat, behavioral evaluation, modifying factors, and action triggers. This systematic review synthesizes over 25 peer-reviewed English studies published between 1974 and 2026, systematically sorting out the HBM’s historical evolution, core dimensional constructs, and internal causal logic. This paper categorizes mainstream application scenarios of the HBM, including chronic disease self-management, preventive screening and vaccination, infectious disease prevention, maternal and child nutrition, and digital health intervention. It further summarizes three popular theoretical integration modes, and comprehensively critiques prominent limitations of the original HBM, such as overemphasis on rational cognition, neglect of emotional and structural factors, static theoretical assumptions, and weak cross-cultural adaptability. On this basis, this review proposes targeted future research agendas covering extended construct supplementation, cross-cultural comparative research, longitudinal dynamic design, multi-theory integration, and structural factor embedding. The findings enrich the theoretical depth of health psychology and public health intervention research, and provide standardized theoretical references for designing targeted health education programs for diverse populations.