The impact of patients' perceptions of high blood pressure on attendance at screening : An extension of the health belief model

This study is concerned with a neglected area: the synthesis of two approaches relevant to health-related behaviour--the Health Belief Model and Attribution Theory. A prospective design was used to test the combination of health beliefs and causal attributions that predispose patients to attend a screening for raised blood pressure. It was proposed that causal attributions concerning high blood pressure (HBP) would (i) affect other health beliefs, (ii) would act in conjunction with health beliefs in relation to actual behaviour and (iii) might show, in some cases, a more direct influence on behaviour and behavioural intention. One hundred and three adults responded to the questionnaire. Multivariate analyses were used to discriminate between the characteristics of attenders and non-attenders. The general prediction was confirmed: overall, eight factors comparing both HBM and attributional items produced a highly significant discrimination. A correlational analysis revealed a variety of linear relationships between HBM-items and causal attributions. Much of the variance in attendance was accounted for by the intention variable, and multiple regression analysis was performed to examine the determinants or intention, as a significant intervening factor between beliefs and behaviour. Participation bias limits the generalisability of these findings. The potential significance of causal attributions as predictors of both health beliefs and behaviour is nevertheless apparent. The implications of such a synthesis of approaches are discussed in terms of psychological theory and health education.