Otitis media; compliance with the return appintment

Mothers' compliance with recommended health actions for their children has typically been inadequate. Numerous investigators have identified variables related to health behavior. A theoretical formulation, the Health Belief Model, has been found predictive of compliance in a number of studies of low income pediatric populations. Few strategies to improve compliance with health behaviors have been tested. The sample consisted to 100 predominantly middle-class mothers with a child who was subsequently diagnosed with otitis media attending a private pediatric group practice. The Health Belief Model was tested as a predictor of compliance, keeping the return appointment for otitis media. In addition, three strategies for improving compliance were compared with a control group. They included a reminder letter, an information sheet, and an educational discussion. Sixty-five percent of the mothers kept the return appointment. The mothers' perceived susceptibility for the ill child was the only major Health Belief Model component significantly related co compliance. Several Health Belief Model modifying factors-mother's age and education, child's age, number of children at home and number of appointments made and kept in the past-were all significantly related to keeping the return appointment of otitis media. The subjects receiving a mailed reminder letter had a significantly higher compliance rate for the return appointment than all other groups. The findings suggest that the Health Belief Model may not be predictive to compliance in middle-class, private practice populations. Development of a standardized set of questions made available for use in new investigations of the Health Belief Mode would allow more critical analysis of this theoretical framework. Mothers' demographic characteristics may be important predictor of health behavior and should be utilized in developing interventions for improving compliance. More testing of both behavioral and educational intervention strategies is needed for various populations groups in different settings.