Using the Health Belief Model to Explain Clinic Appointment-Keeping for the Management of a Chronic Disease Condition
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Broken appointments have untoward repercussions for patients' health and well-being. Although the literature on missed appointments has been largely atheoretical, several studies have tested the Health Belief Model (HBM) in this context. Those studies have found HBM dimensions are not predictive of keeping appointments for the management of a chronic condition. Given several limitations that characterize these studies, questions can be raised about the validity of this conclusion. This study investigated the utility of HBM for explaining appointment-keeping for Systemic Lupus Erythematosus (SLE), a potentially fatal chronic disease. A questionnaire, operationalizing HBM dimensions and exhibiting acceptable psychometric properties, was developed for this research and administered to 153 SLE patients enrolled at an outpatient clinic of a major teaching hospital. In addition to measuring intention to keep appointments, data were abstracted from medical records regarding actual appointment-keeping during 12 months prior to and 6 months following questionnaire completion. Regression analysis indicated that general health motivation and perceived severity of SLE were uniquely associated in the theoretically predicted direction with, respectively, intent and the percentage of scheduled appointments kept (PSAK) during the 12 month retrospective period. Perceived costs was associated in the expected direction with intent, 12 month retrospective and 6 month prospective PSAK. Typical of HBM research the effect sizes uncovered were modest in magnitude. Questions for future investigation are discussed.
- Andrews R, Morgan JD, Addy DP, McNeish AS. Understanding non-attendance in outpatient pediatric clinics. Arch Dis Child 1990;65:192-195.
- Macharia M, Leon G, Rowe BH, Stephenson B, Haynes RB. An overview of inter ventions to improve compliance with appointment keeping or medical services. JAMA 1992;267:1813-1817.
- Keife CI, Harrison PL. Post-hospitalization followup appointment-keeping among the medically indigent. J Comm Health 1993;18:271-282.
- Becker MH. The health belief model and sick role behavior. Health Educ Monogr 1974; 2:409-419.
- Becker MH, Drachman RH, Kirscht JP. A new approach explaining sick-role behavior in low income populations. Am J Pub Health 1974; 64:205-216.
- Becker MH, Haefner DP, Maiman LA, et al. The health belief model and prediction of dietar y compliance: A field experiment. J Health Soc Behav 1977; 18:348-366.
- Zweig S, LeFevre M, Kruse J. The health belief model and attendance for prenatal care. Fam Pract Res J 1988; 8:32-41.
- Wells RD, McDiarmid J, Bayatpour M. A cost-effective technique for predicting prenatal appointment keeping rates among pregnant teenagers. J Adolescent Health Care 1990;11:119-124.
- Kash KM, Holland JC, Haper MS, Miller DG. Psychological distress and surveillance behaviors of women with a family history of breast cancer. J Nat Cancer Inst 1992; 84:24-30.
- Becker MH, Nathanson CA, Drachman RH, et al. Mothers' health beliefs and children's clinic visits. A prospective study. J Comm Health 1977; 3:125-135.
- Irwin CE, Millstein SG, Ellen JM. Appointment keeping behavior in adolescents: Factors associated with follow-up appointment-keeping. Pediatrics 1993; 92:20-23.
- Williams R. Illness visualization and therapeutic adherence. J Fam Pract 1989; 28:185-190.
- Jones SL, Jones PK, Katz J. Compliance in acute and chronic patients receiving a health belief model inter vention in the emergency department. Soc Sci Med 1991; 32:1183-1189.
- Nelson EC, Stason WB, Neutra RR, Solomon HS, McArdle PJ. Impact of patient perception on compliance with treatment for hypertension. Med Care 1978; 16:893-906.
- Landers R, Riccobene A, Beyreuther M, Neusy AJ. Predictors of long-term compliance in attending a worksite hypertension programme. J Hum Hypertens 1993; 7:577-579.
- Connelly CE. Compliance with outpatient lithium therapy. Perspectives in psychiatric care 1984; 22:44-50.
- Beazley DL, Paris DR, Partingron JT. Correlates of compliance among chiropractic patients treated for low back pain. J Manipulative and Physiological Therapeutics 1986; 9:125-129.
- Brent EE, Mirielli EJ, Thompson A. Ex-Sample: An Expert System for Determining Sample Size. Version 3. Columbia MO: Idea Works, Inc., 1993.
- Becker MH, Kabak MM, Rosenstock IM, Ruth MV. Some influences on public participation in a genetic screening program. J Comm Health 1975; 1:3-14.
- Maiman LA, Becker MH, Kirscht JP, Haefner DP, Drachman RH. Scales for measuring health belief model dimensions: A test of predictive value, internal consistency and relationships among beliefs. Health Educ Monogr 1977; 5:215-230.
- Crowne DP, Marlowe D. A new scale of social desirability independent of psychopathology. J Consult Psychol 1960; 24:349-354.
- Jackson DN. A sequential system for personality scale development, in Spielberger CD (ed.): Current Topics in Clinical and Community Psychology 2:61-96, New York: Academic Press, 1970.
- Harrison JA, Mullen PD, Green LW. A meta-analysis of studies of the health belief model with adults. Health Educ Res 1992; 7:107-116.
- Janz N, Becker MH. The health belief model: a decade later. Health Educ Q 1984; 11:1-47.
- Richardson MA, Simons-Mortaon B, Annegers JF. Effect of perceived barriers on compliance with antihypertens ive medication. Health Educ Q 1993; 20:489-503.
- Joreskog KG, Sorbom, D. LISREL 7: A guide to the program and applications. Chicago: SPSS, 1988.
- Sackett DL, Snow JC. The magnitude of compliance and noncompliance, in Haynes RB, Taylor DW and Sackett DL (eds.): Compliance in Health Care. Baltimore: The Johns Hopkins University Press, 1981, pp. 11-22.
- Cohen J, Cohen P. Applied Multiple Regression/Correlation Analysis for the Behavioral Sciences. Hillsdale, New Jersey: Lawrence Earlbaum Associates, 1983.
- Sheeran P, Abraham C. The health belief model, in Conner M, Norman P (eds.): Predicting Health Behaviour. Philadelphia: Open University Press, 1996, pp. 23-61.
- Petri M, Perez-Gutthann S, Longenecker C, Hochberg M. Morbidity of systemic lupus erythematosus: Role of race and socioeconomic status. Am J Med 1991; 91:345-353.
- Deyo RA, Inui TS. Dropouts and broken appointments. Med Care 1980; 18:1146-1157.
- Maddux JE, Rogers RW: Protection motivation and self-efficacy; A revised theory of fear appraisals and attitude change. J Experimental Soc Psychol 1983; 9:469-479.
- Conner M, Sparks P. The theory of planned behaviour and health behaviours, in Conner M, Norman P (eds.): Predicting Health Behaviour. Philadelphia: Open University Press, 1996, pp. 121-162.
- Kirscht JP. The health belief model and predictions of health behavior, in Gochman DS (ed.): Health Behaviors. New York: Plenum Press, 1988, pp. 27-41.
- Dishman RK, Ickes W, Morgan W. Self-motivation and adherence to habitual physical activity. J Appl Soc Psychol 1980; 10:115-132.
- Using the Health Belief Model to Explain Clinic Appointment-Keeping for the Management of a Chronic Disease Condition
Journal of Community Health
Volume 23, Issue 3 , pp 195-210
- Cover Date
- Print ISSN
- Online ISSN
- Kluwer Academic Publishers-Plenum Publishers
- Additional Links