Irwin C E, Millstein S G, Ellen J M
Department of Pediatrics, School of Medicine, University of California, San Francisco 94143.
Pediatrics. 1993 Jul;92(1):20-3.
To identify the sociodemographic and Health Belief Model predictors of follow-up appointment-keeping behavior.
Prospective observational study.
General adolescent medical clinic.
Sequential sample of 166 adolescents (aged 12 to 20 years, mean = 15.9 years) enrolled in the clinic. The population was 75% female; the racial-ethnic distribution of the sample was 37.9% black, 29.8% white, 11.2% Asian, 14.3% Hispanic, and 6.8% "other" background. Subjects' social class was primarily lower-middle (60.5%) and middle class (28.6%). A subsample was randomly assigned to be interviewed about their beliefs concerning their follow-up appointment and the constructs of the Health Belief Model.
Forty-eight percent of the total sample failed to keep their follow-up appointment. There was a significant positive correlation between social class and appointment keeping (F = 5.07; df = 5,110; P = .026). Neither race-ethnicity nor who made the appointment were found to be associated with follow-up appointment-keeping. The only construct of the Health Belief Model found to be significantly associated with appointment keeping was the number of potential negative outcomes resulting from noncompliance perceived by the subject (F = 6.85; df = 1.74; P = .011).
Clinicians must work with adolescents to improve their understanding of the potential negative outcomes associated with noncompliance to improve appointment-keeping behavior.
确定后续预约遵守行为的社会人口统计学和健康信念模型预测因素。
前瞻性观察性研究。
青少年综合医疗诊所。
该诊所登记的166名青少年（年龄12至20岁，平均15.9岁）的连续样本。人群中75%为女性；样本的种族-民族分布为37.9%黑人、29.8%白人、11.2%亚洲人、14.3%西班牙裔和6.8%“其他”背景。受试者的社会阶层主要为中下层（60.5%）和中产阶级（28.6%）。一个子样本被随机分配接受关于他们对后续预约的信念以及健康信念模型结构的访谈。
总样本中有48%未能遵守后续预约。社会阶层与预约遵守之间存在显著正相关（F = 5.07；自由度 = 5,110；P = .026）。未发现种族-民族和预约者与后续预约遵守有关。健康信念模型中唯一与预约遵守显著相关的结构是受试者感知到的不遵守规定所导致的潜在负面结果数量（F = 6.85；自由度 = 1.74；P = .011）。
临床医生必须与青少年合作，以提高他们对不遵守规定相关潜在负面结果的理解，从而改善预约遵守行为。
