The role of social cognition models in predicting attendance at health checks

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Abstract
The present study sought to apply the Health Belief Model and the Theory of Planned Behaviour to the prediction of attendance at health checks. In addition, the way in which patients were invited to the health checks and the effect this had on both the uptake of the service and the role of cognitive factors in predicting attendance was analysed. Based in a single general practice, 818 patients were either sent an invitation letter which included an appointment time or they were sent an open invitation to contact the practice to make their own appointment time. Prior to the commencement of the programme health belief questionnaires were sent to patients. The results of the study firstly showed that letters offering patients an appointment produced a much higher attendance rate (70%) than letters containing an open invitation (37%). Secondly, through stepwise discriminant function analyses, the predictors of attendance behaviour were found to vary according to how patients were invited. For patients sent an appointment, attenders were found to be more likely than non-attenders to place a high value on their health, to believe that their health is influenced by powerful others, that certain referent groups would advise them to attend, that attending would lead to positive outcomes and that motivational barriers would not prevent them from attending. For patients sent an open invitation, intention to attend and perceived control were found to be independent predictors of attendance behaviour. These results suggest that attendance at health checks may not be a homogeneous behaviour such that the beliefs which distinguish attenders and non-attenders may be seen to vary according to the way in which the service is offered.