Standard Definitions of Adherence for Infrequent yet Repeated Health Behaviors

Duke University-Division of General Internal Medicine, Durham VAMC-Center for Health Services Research in Primary Care, Durham, NC 27701, USA.
American journal of health behavior (Impact Factor: 1.31). 01/2010; 34(6):669-79. DOI: 10.5993/AJHB.34.6.4
Source: PubMed


To present common language for defining adherence of infrequent yet repeated health behaviors.
We illustrate methodological and conceptual issues using human papillomavirus (HPV) vaccination and screening mammography study data as examples.
Adherence rates of infrequent, repeated behaviors varied widely depending on how adherence was defined and measured. We advocate use of 3 standard definitions of adherence: initiation of behavior (initiation), adherence to most recent opportunity (on-schedule), and timely adherence across multiple opportunities (maintenance or completion).
The proposed framework has cross-cutting implications for research and practice. Standardizing adherence metrics may facilitate comparisons across studies of health behaviors practiced at infrequent yet repeated intervals.

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Available from: Jennifer M Gierisch, Jun 03, 2014
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    • "The data do not capture short-term changes in behavior since health behaviors are recorded at interviews about two years apart. This measurement of behaviors at infrequent but regular intervals is similar to the study of the maintenance of HPV screening and mammography (Gierisch et al. 2010). This study of adherence starts with the first observed healthy change, which for most respondents is the only healthy change. "
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    • "As we have done in previous reports (Gierisch et al., 2010a), we used days between mammograms as our outcome. This option is more sensitive to smaller variations in adherence than a dichotomous outcome (Gierisch et al., 2010b). We tested three hypotheses. "
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