USING THE HEALTH BELIEF MODEL TO EXPLAIN CLINIC APPOINTMENT-KEEPING FOR THE MANAGEMENT OF A CHRONIC DISEASE CONDITION

Broken appointments have untoward repercussions for patients' health a nd well-being. Although the literature on missed appointments has been largely atheoretical, several studies have tested the Health Belief M odel (HBM) in this context Those studies have found HEM dimensions are not predictive of keeping appointments for the management of a chroni c condition. Given several limitations that characterize these studies , questions can be raised about the validity of this conclusion. This study investigated the utility of HEM for explaining appointment-keepi ng for Systemic Lupus Erythematosus (SLE), a potentially fatal chronic disease. A questionnaire, operationalizing HEM dimensions and exhibit ing acceptable psychometric properties, was developed for this researc h and administered to 153 SLE patients enrolled at an outpatient clini c of a major teaching hospital. In addition to measuring intention to keep appointments, data were abstracted from medical records regarding actual ap pointment-keeping during 12 months prior to and 6 months fo llowing questionnaire completion. Regression analysis indicated that g eneral health motivation and perceived severity of SLE were uniquely a ssociated in the theoretically predicted direction with, respectively, intent and the percentage of scheduled appointments kept (PSAK) durin g the 12 month retrospective period. Perceived costs was associated in the expected direction with intent, 12 month retrospective and 6 mont h prospective PSAK. Typical of HEM research the effect sizes uncovered were modest in magnitude. Questions for future investigation are disc ussed.