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The health belief model: predicting compliance and dropout in cardiac rehabilitation
1Department of Physical Education, McMaster University, Hamilton, Ontario, Canada.
Insights
The health belief model effectively predicts cardiac rehabilitation compliance, improving predictions beyond demographics and health behaviors. Health locus of control did not significantly predict adherence.
Area of Science:
- Cardiology
- Health Psychology
- Behavioral Science
Background:
- Cardiac rehabilitation is crucial for patients with coronary artery disease.
- Patient adherence to cardiac rehabilitation programs significantly impacts outcomes.
- Predicting adherence remains a challenge, impacting program effectiveness.
Purpose of the Study:
- To evaluate the predictive utility of the health belief model and health locus of control for cardiac rehabilitation adherence.
- To determine if these psychological constructs enhance predictions beyond standard demographic and health behavior variables.
- To differentiate between compliers and dropouts, including avoidable and unavoidable dropout reasons.
Main Methods:
- Discriminant function analysis was used to predict group membership (compliers vs. dropouts).
- 120 coronary artery disease patients completed baseline questionnaires assessing health belief model and health locus of control.
- Patient demographics and health behaviors were also assessed for comparative analysis.
Main Results:
- The health belief model predicted group membership with 64.6% accuracy, explaining 5.2% of the variance.
- Incorporating the health belief model with demographics and health behaviors improved prediction accuracy to 74.4% for overall dropout.
- The combined model achieved 84.2% accuracy in predicting avoidable versus unavoidable dropout, explaining 56.9% of the variance.
- Health locus of control did not significantly differentiate between compliers and dropouts.
Conclusions:
- The health belief model offers valuable insights into predicting cardiac rehabilitation adherence.
- Psychological factors, specifically the health belief model, enhance predictive models beyond demographic and behavioral data.
- Understanding the health belief model is key to improving patient engagement and reducing dropout rates in cardiac rehabilitation programs.
Abstract:
We investigated the health belief model and the health locus of control constructs as predictors of group membership (compliers or dropouts) with cardiac rehabilitation and whether they added predictive utility to routinely assessed patient demographics and health behaviors. Questionnaires were completed on entry into the study by 120 patients with coronary artery disease, and by the end of the 6 month program there were 58 compliers and 62 dropouts. Discriminant function analyses were carried out to determine prediction of group membership. The health belief model predicted group membership 64.6% of the time, explaining 5.2% of the variance. Demographics, health behaviors, and health belief model factors accounted for 21.1% of the variance between compliers and total dropouts with group membership correctly predicted 74.4% of the time; avoidable and unavoidable dropout was correctly predicted 84.2% of the time with 56.9% of the variance explained. Health locus of control did not distinguish between compliers and dropouts. The addition of the health belief model provided additional information about compliance with cardiac rehabilitation beyond that explained by demographic and health behavior variables alone, particularly when predicting avoidable/unavoidable dropout.