Although adherence to medical instructions is usually essential to successful health outcomes, compliance rates (especially in low-income populations) are very inadequate, and little is known about factors influencing such sick-role behaviors. The present study examines the explanatory value of a behavioral model, derived from social psychological theory, and employing health motivations, perceptions, and attitudes of mothers as predictors of compliance with regimens prescribed for their children. poor compliance in pediatric clinic populations identify a public health concern of considerable magnitude.S57 The situation is typified by Bergman and Werner's8 study of clinic children placed on the 10-day course of penicillin necessitated by streptococcal infections. While about 90 per cent of the parents correctly reported their child's diagnosis and knew the name of the medicine and the proper way to administer it, 56 per cent of the patients were not receiving the medication by the 3rd day; 71 per cent had stopped by the 6th day; and by the 9th day only 18 per cent were still receiving penicillin. Given further qualifications of free medication, physician awareness of the study, and advance notification of families that they would be visited "to see how the child was doing," these disturbing findings probably represent conservative estimates of actual noncompliance in low income populations.Unfortunately The current research attempts to test empirically' a "behavioral" model of compliance, based on social psychological theory' 2,1 3 and relying mainly on motivational and cognitive factors. The model borrows heavily from an existing public health formulation, the "Health Belief Model," constructed to predict "preventive" health behaviors such as obtaining annual checkups, tuberculosis and Papanicolaou screening tests, and prophylactic dental ViSitS.1 4-1 8The elements of the traditional Health Belief Model are displayed in Figure 1; they include the individual's perceptions of susceptibility to a disease, the severity of the disease, and the benefits and costs associated with paths of action that can be taken to prevent it. These perceptions are affected by diverse demographic, structural, and sociopsychological variables. A "cue" or triggering mechanism is also held to be necessary for initiating appropriate action.Rosenstock' 8 has reviewed in detail the components of the model and the empirical support for it. Some reviewers' X have stated that these variables provide a satisfactory explanation for the majority of findings in the area of preventive health behavior, and recent research' 9 has confirmed that they can explain some aspects of health action prospectively.There would seem to be no inherent reason why the same type of formulation should not apply to actions taken by individuals who know that they are ill in order to become well, especially if the concept of susceptibility is extended to mean the probability of progressive effects or of recurrence. For example, Heinzelmann20 has demonstrated continued ...
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