Interrelationships among preventive health behaviors: a test of competing hypotheses.

Abstract

THE DETERMINANTS OF THOSE BEHAVIORS that people can control to lessen the probability of chronic disease or a major accident have received increasing emphasis in recent years. An expanding volume of research seeks to explain observed differences in people's preventive health behavior in terms of differing social-psychological attributes of individuals (1,2), properties of varying social milieus of persons and groups (3-5), or in terms of both these differentials (3,6). Although each of these approaches has been used successfully in some studies to account for variation in specific preventive behaviors, other studies using these approaches have not been able to account satisfactorily for variations in behavior. In spite of the proliferation of studies on preventive health behavior, little attention has been paid to the dependent variable itself. Yet, the failure of studies to account consistently for differences in preventive health behavior may result as much from poor conceptualization and measurement of the dependent variable as from inadequacies in the theoretical frameworks constructed to explain such behavior. Before we can explain variations in preventive health behaviors, we need a better understanding of the interrelationships among these behaviors. Whether preventive health behavior is best conceptualized as a unidimensional phenomenon, as a collection of disparate behaviors, or possibly as multidimensional is not clear. If it is unidimensional, then any preventive behavior will work equally well as the dependent variable, and failures to account for observed differences in preventive health behaviors must be explained on the basis of measurement errors or insufficient development of the explanatory model. If, however, preventive health behavior is either multidimensional or a collection of unrelated behaviors, then inductive model-building based on the assumption that any behavior is representative of the universe of preventive behaviors is likely to be inadequate. To clear the way for a more comprehensive theory of preventive health behavior, the relationships between 11 kinds of preventive behaviors were explored in the current study.

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