Literature Review: The Health Belief Model as an Educational Intervention Framework to Improve Tuberculosis Therapy Adherence

Literatur Review: Health Belief Model sebagai Kerangka Intervensi Edukasi untuk Meningkatkan Kepatuhan Terapi

Abstract

Tuberculosis remains a major health problem with a high morbidity burden and the risk of therapy failure if treatment is not completed, partly due to low patient adherence to long-term drug regimens. The Health Belief Model (HBM) is widely used as a theoretical framework to explain and modify health behavior through changes in perceptions of susceptibility, seriousness, benefits, barriers, cues to action, and self-efficacy. This article presents a narrative review of five articles applying the HBM in the context of tuberculosis, comprising three cross-sectional studies identifying determinants of adherence, one pre-experimental study testing the effect of HBM-based education, and one conceptual review article, focusing on HBM constructs and outcomes related to medication adherence or motivation. Each article was reviewed to identify study design, respondent characteristics, intervention format or analytical focus, HBM construct indicators, and outcome assessment methods. The results were then synthesized descriptively due to heterogeneity in design and outcomes. The synthesis showed that strengthened threat perception, clarified benefits of therapy, reduced perceived barriers, and strengthened self-efficacy were consistently associated with improved medication adherence or motivation, both in observational and intervention studies. However, the predominance of cross-sectional designs and limitations in outcome measurement require caution in generalizing the findings and inferring causality. Overall, the HBM appears to have potential for integration into TB patient education and support programs in healthcare settings, and further experimental research with a more robust methodological design is needed to confirm its effectiveness.