SEEKING AND USING HEALTHCARE SERVICES

A. Seeking Healthcare
1. Theoretical models of health-related behavior
  a. Health belief model
    (1) Perceived susceptibility and severity
    (2) Perceived benefits and barriers
  b. Theory of reasoned action
    (1) Individual beliefs and social influence
    (2) Balance between personal attitudes and subjective norms
    (3) Intention to act and action
  c. Theory of planned behavior
    (1) TRA plus perceived behavior control
  d. Self-regulation theory
  e. Stage theories
    (1) Precaution adoption process model
    (2) Transtheoretical model
2. Testing the theoretical models
3. Illness behavior
  a. Distinguishing illness and disease
  b. Responding to symptoms
    (1) Reluctance to seek help
    (2) Social and demographic influences
    (3) Symptom characteristics: visibility, severity, interference, frequency/persistence
    (4) Understanding of the illness
4. The sick role
  a. Rights and duties of being sick
  b. Choosing the provider: traditional vs. non-traditional practitioners and remedies
5. Being a hospital patient
  a. The experience
    (1) Non-person status
    (2) Lack of information
    (3) Loss of control
  b. “Good” vs. “bad” patients
  c. Preparing for hospitalization and surgery
    (1) The negative effects of inadequate preparation
    (2) Coping strategies
    (3) Working with children

B. Adherence
1. The importance of adherence
2. Theories of adherence
  a. Behavioral models
    (1) Positive reinforcement
    (2) Punishment and negative reinforcement
  b. Cognitive models
    (1) Self-efficacy
    (2) TRA and HBM
3. Studying adherence
  a. Where do we get the information?
  b. What forms of non-adherence should be studied?
    (1) Taking medications
    (2) Keeping appointments
    (3) Changing behaviors
  c. How frequent is non-adherence?
  d. What factors predict adherence and non-adherence?
    (1) Illness characteristics
    (2) Treatment characteristics
    (3) Patient characteristics
    (4) Social and cultural norms
    (5) Patient-practitioner interaction
4. Improving patient adherence
  a. Educational strategies
    (1) Information
    (2) Threats
  b. Behavioral strategies
    (1) Cues and prompts
    (2) Training
    (3) Reinforcers
  c. Cognitive strategies
    (1) Enhancing self-efficacy
    (2) Self-monitoring and feedback
5. Does improved adherence make a difference?

Copyright ©1998 Beverly J. Volicer and Steven F. Tello, UMass Lowell.  You may freely edit these pages  for use in a non-profit, educational setting.  Please include this copyright notice on all pages.