Precaution Adoption Model

The Precaution Adoption Model (PAM) is a theoretical paradigm of preventive behavior.  It defines an orderly sequence of cognitive steps that individuals must complete in order to modify behavior. (8)

Like the Transtheoretical Model (TTM), PAM is a theory comprising multiple stages.  It assumes two important points:

• People at specific points of the PAM behave differently than those in other parts of the model. 


• The types of interventions that move people closer to action vary by stage.

The PAM has seven stages.  The first three stages address an individual’s belief about his or her susceptibility to harm.  A person in the first stage is unaware of the hazard.  In the second stage, the person has heard of the hazard, but does not necessarily apply it to himself.  This stage may include optimistic bias, the incorrect belief that one's own risk is less than that of others.  Given vague information, obtained from mass media or acquaintances, people may fail to personalize their own risk.  In the third stage, additional hazard messages have convinced the person that the risk is personally significant.  Personal experience, education about specific risk factors, and witnessing of precautions taken by peers can all help move a person to this stage. 

According to the PAM, once a person perceives a significant personal threat, he or she will examine the severity of the hazard, look at the effectiveness of precautions, and calculate the cost involved before deciding whether to act.  (Cost is defined in terms of time and effort, monetary expense, undesirable side effects, and loss of pleasure secondary to behavior change.)  This process leads to the next three stages of the PAM: the decision to act or not to act and the action itself.

Finally, if the person takes action and then chooses to continue the behavior he has started, he may reach a seventh stage: maintenance of the behavior.