Mothers' health beliefs and children's clinic visits - A prospective study

This paper reports results from a prospective study of the relationship between mothers' health attitudes and beliefs and their utilization of pediatric clinic services for their children. Attitudinal data were obtained in interviews with a random sample of mothers attending the Children and Youth clinic of a large teaching hospital; data about children's clinic visits during a period of 3 1/2 years subsequent to the interview were abstracted from their medical records. Four aspects of clinic utilization were examined: visits for well-child care; acute-illness visits; accident-related visits; and appointment keeping. Health attitudes were found to be associated with both preventive and illness/accident visits, but in opposite directions. Mothers with an active, interventionist orientation towards health care and mothers who attributed good health and low illness-susceptibility to their children were high users of preventive services and generated few illness/accident visits. Conversely, more passive mothers, and mothers who perceived their children to be in poor health and susceptible to illness, were responsible for fewer well-child and more illness/accident visits. Mothers' agreement with the physician's diagnosis at the index visit was an additional strong predictor of use of well-child services, while disagreement was associated with more visits for illness and accidents. The convenience of appointment times and general satisfaction with the clinic were the best predictors of appointment keeping. These results indicate the importance of distinguishing between different dimensions of health care utilization in studies that attempt to account for this behavior; they also suggest that modification of health attitudes may prove to be an effective way to bring about positive changes in patterns of health services use.