Within the health care world, compliance refers to individuals’ willingness to follow medical advice. The most commonly used framework for studying com- pliance to medical advice is the health belief model. The model was developed to explain why healthy individuals adopt healthy behaviors. According to the model, four factors affect these deci- sions: Individuals must believe (1) that they are susceptible to a particular health problem, (2) that the problem is serious, (3) that adopting preventive measures will reduce their risks significantly, and (4) that no significant barriers make it difficult for them to adopt those measures. For example, people are most likely to adopt a low-fat diet if they believe that otherwise they will face high risks of heart disease, that heart disease will substantially decrease their life expectancy, that a low-fat diet will substantially reduce their risk of heart disease, and that such a diet won’t be too costly, inconvenient, or unpleasant. In turn, according to the health belief model, these four factors are affected by demographic variables (such as the indi- vidual’s gender and age), psychosocial variables (such as personality characteristics and peer group pressures), structural factors (such as access to knowledge about the problem and contact with those who experience the problem), and external cues to action (such as media campaigns about the problem or doctors’ advice). “Key Concepts: The Health Belief Model,” outlines how this model works.
Although this model recognizes that social factors as well as individual psy- chological factors affect health decision making, in practice it is most often used to explain individual choices. In other words, researchers who use this model tend to emphasize agency—individual free will to make choices—over structure—social forces that limit the choices individuals realistically can make. As a result, such researchers, along with most policy makers, more often promote policies such as educating consumers about the dangers of smoking than policies such as banning smoking in public places. The debate over the relative impor- tance of agency and structure—sometimes referred to as “life choices” versus “life chances”—is at the center of many theoretical discussions within sociology and, even more so, between sociology and other fields such as psychology and medicine.
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