Janet Katz

Health belief model intervention to increase compliance with emergency department patients.

The effects on compliance of clinical and telephone intervention, based on the Health Belief Model (HBM), were investigated for 842 Emergency Department (ED) patients. The influence of mediating variables on compliance was also examined. Compliance was defined operationally as follow-through on a recommended referral originating in the ED. The study design was a 2 X 2 X11 factorial design, in which the first factor was the HBM clinical intervention, the second was the HBM telephone intervention, and the third was the type of presenting problem. Patients were randomly assigned to one of four intervention groups, with all nursing care, interventions, and follow-up telephone calls being done by the research nurse. The HBM clinical, telephone, and combination clinical/telephone interventions were strongly associated with increased compliance in the 11 presenting problems. Availability of child care, knowledge of presenting problem, nature and duration of the illness, and demographic variables (such as age of the patient) were also related to compliance

Improving compliance for asthmatic patients visiting the emergency department using a health belief model intervention.

The sample included 74 asthmatic patients presenting to an emergency department with an acute asthmatic attack. The purposes of the study were: to assess demographic and situational variables associated with compliance, and to test the impact of a Health Belief Model (HBM) intervention to increase compliance. Compliance was operationalized as making and/or keeping a follow-up referral appointment for the patients asthmatic condition. Demographic and situational variables associated with compliance included age, sex, marital status, previous treatment experience, seriousness of the asthmatic condition, and need for child care. Most important, the HBM intervention was very effective in increasing compliance in both making and keeping a follow-up referral appointment.

A Randomized Trial to Improve Compliance in Urinary Tract Infection Patients in the Emergency Department

A randomized trial was used to evaluate two forms of a health belief model (HBM) intervention aimed at increasing compliance among 139 patients with urinary tract infections who presented to the emergency department. Patients who received an HBM clinical intervention administered in the ED, HBM telephone intervention two to four days after the ED visit, or both interventions were much more likely than control patients to both schedule and keep a follow-up referral appointment. Both the clinical and telephone interventions were designed to increase perceived susceptibility to complications of the urinary tract infection, seriousness of the complications, and benefits and costs of action. Other factors predicting compliance include age of the patient, urgency of the urinary tract infection as rated subjectively by the emergency physician, need for child care, whether transportation was available, and questioning the nurse about the referral appointment.

Compliance in acute and chronic patients receiving a health belief model intervention in the emergency department.

We compared compliance behavior in acute (n = 670) and chronic (n = 172) patients visiting the Emergency Department (E.D.) of an acute care, private hospital; compliance was operationalized as scheduling or keeping a follow-up referral appointment originating in the Emergency Department. The purposes of the study were to assess demographic and illness experience differences among patients and to assess the relative impact of a Health Belief Model Intervention on compliance in acute versus chronic patients. Within the acute and chronic categories patients were randomized into four experimental groups to test the efficacy of the HBM intervention. Although chronic patients were generally more compliant than acute patients, the HBM interventions were equally effective in increasing compliance in both groups. Chronic patients were older, more likely to have had previous treatment for an illness, and more likely to regard the potential consequences of their illness as serious; these factors were associated with greater compliance.