Predicting and Understanding Influenza Vaccination Behavior. Alternatives to the Health Belief Model

Recent reviews indicate that attempts to validate the Health Belief Model (HBM) have produced only modest support for it and that the HBM may be incomplete in its organization and development as an expectancy-value model. As an alternative, the Fishbein and Triandis models are discussed. The author investigated the utilities of the Fishbein and Triandis models as predictors of behavioral intention and behavior, using obtaining versus not obtaining an influenza vaccination as the health behavior. Eligible participants were patients at high risk for flu complications, registered at the Seattle VA Medical Center's Medical Comprehensive Care Unit (MCCU) clinic. A random sample of 439 patients was selected to participate in a two-wave longitudinal survey in which the Fishbein and Triandis model components were assessed at the beginning of the 1983 flu season, and a measure of flu shot-getting behavior was obtained at the end of the season. Both models accounted for significant and substantial proportions of variance in intentions and behavior. Comparisons of these models revealed that the three-component Triandis Intention model and the overall Triandis model were superior to the Fishbein model in predicting intention and behavior. The potential use of this model for developing interventions is discussed.