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Updated: Jun 11, 2026

Using Continuous Data Tracking Technology to Study Exercise Adherence in Pulmonary Rehabilitation
Published on: November 8, 2013
Standard definitions of adherence for infrequent yet repeated health behaviors
Jennifer M Gierisch1, Paul L Reiter, Barbara K Rimer
1Duke University-Division of General Internal Medicine, Durham VAMC-Center for Health Services Research in Primary Care, Durham, NC 27701, USA. j.gierisch@duke.edu
Objective:
To present common language for defining adherence of infrequent yet repeated health behaviors.
Methods:
We illustrate methodological and conceptual issues using human papillomavirus (HPV) vaccination and screening mammography study data as examples.
Results:
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).
Conclusions:
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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