Deterrents to well-child supervision

Health Service Appointment Keeping

Appointment keeping was described as a chain of behavior which results in a health service client attending an appointment. The environmental cues and consequences, both aversive and reinforcing, which might impact each behavior in this chain were illustrated and described as either strengthening or weakening appointment keeping. Appointment keeping surveys and experimental research were reviewed in the context of this behavioral profile, as well as methodological soundness. Survey studies broadened our understanding of appointment keeping by pinpointing populations in special need, but few changeable variables (e.g., behavior of health care team or delivery system, physical environment, and so on) were found to be related to appointment keeping. A number of intervention studies showed increased appointment adherence coincidental with the use of reminders and reinforcing consequences. Thus, it was concluded that a behavioral profile could focus investigators' attention on potentially changeable variables which might improve adherence to health service appointments. Suggestions for future research are made.

Multiple influences on the acquisition and socialization of children's health attitudes and behavior: an integrative review

An overview and synthesis of the literature documenting various influences on the socialization and acquisition of children's health attitudes and behavior is the focus of this review. Cognitive-developmental approaches to understanding children's health attitudes are presented, followed by an exploration of an individual differences perspective on children's acquisition of health attitudes and behavior. The influence of various socialization agents, including families, peers, schools, and the media, on children's acquisition of health attitudes and behavior is considered. Implications of these findings for social policy, future research, and modeling of child health attitudes and behavior are examined.

Mothers' health beliefs and use of well-baby services among a high-risk population

The relationship between mothers' health beliefs and use of well-baby services among a poor, minority, high-risk population is reported. Data were collected from 61 black mothers attending a maternal-child clinic by interviews at the first and sixth months after the birth of their infants. The analysis focused on four health beliefs (susceptibility, severity, benefits, and efficacy) and two health behaviors (clinic visits and immunizations during the first 6 months). Although mothers' health beliefs were not predictive of clinic visits, health beliefs at the sixth month accounted for 30% of the variance in the number of immunizations. This relationship was dominated by perceived efficacy of immunizations and perceived benefits of well-baby services. The findings indicate a need to consider the nature and extent of possible changes in relationships between health beliefs and health behaviors over time.

Morbidity in Canadian Indian and non-Indian children in the first year of life

A cohort study of health status was undertaken to determine the patterns of morbidity in the first year of life for Indian and non-Indian infants living in southern Ontario. The annual incidence of office-reported health problems was 8.0 episodes for the 99 Indians and 4.5 for the 316 non-Indians studied. The risk of illness of most diagnostic categories was more than 1.5 times greater and the rate of hospital admission 4 times greater for the Indian infants. There was no difference between the two cohorts in the rates of visits to hospital emergency departments. The main cause of illness in both cohorts was respiratory tract infection; lower respiratory tract infections, particularly pneumonia, were a major health problem among the Indian infants. Only 36% of the Indian infants compared with 68% of the non-Indian infants attended five or more well-baby examinations. Part of the difference in morbidity between the Indian and non-Indian infants may be attributed to environmental factors, health care behaviour and geographic constraints.

Patterns of maternal desires for child health care

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