Wheeler J R, Rundall T G
Health Educ Q. 1980 Winter;7(4):243-62. doi: 10.1177/109019818000700401.
A comprehensive model of secondary preventive health behavior, defined as the use of physician services for preventive care, is constructed which specifies the interrelationships among people's health beliefs, their health status, their accessibility to care, their sociodemographic characteristics, and their use of services. The model is tested by applying path analysis to a household survey of adult residents of Washtenaw County, Michigan. The results support the contention that many factors influence secondary preventive utilization, some principally directly and some largely indirectly through their effects on other variables. Accessibility to care, health status, health beliefs, and sex all directly influence use, while education and age have indirect effects. Income has indirect effects on use which, because they are in opposing directions, cancel each other out.
构建了一个二级预防健康行为的综合模型，该模型将二级预防健康行为定义为利用医生服务进行预防保健，它明确了人们的健康信念、健康状况、获得医疗服务的机会、社会人口学特征以及他们对服务的使用之间的相互关系。通过对密歇根州沃什特瑙县成年居民的家庭调查应用路径分析来检验该模型。结果支持了这样的观点，即许多因素会影响二级预防服务的利用，一些因素主要直接起作用，一些因素则主要通过对其他变量的影响间接起作用。获得医疗服务的机会、健康状况、健康信念和性别都直接影响服务的使用，而教育程度和年龄则有间接影响。收入对服务使用有间接影响，由于这些影响方向相反，相互抵消。
