We tested the predictive utility of the health belief model (HBM) for adherence with a complex, ongoing medical regimen in the context of a chronically ill youthful population (56 adolescent outpatients with insulin-dependent diabetes mellitus; mean age = 14 years). A three-construct model of health beliefs was tested: Threat (perceived susceptibility combined with severity), Benefits-Costs, and Cues to seek treatment. Multiple indicators of compliance were used, and metabolic control was measured by glycosylated hemoglobin. The Benefits-Costs and Cues constructs were related to compliance in the theoretically expected positive direction. Threat interacted with Benefits-Costs in the prediction of compliance and with Cues in the prediction of metabolic control. The greatest compliance was achieved with low perceived Threat and high perceived Benefits-Costs. Poor metabolic control was associated with high Threat and Cues. As age increased, adherence to the exercise, injection, and frequency components of the regimen decreased.
Children's abilities to search for missing objects in real-life environments were investigated in two studies using children aged 2-6 years. In the first study we investigated searches of eight locations on a school playground; in the second, searches of eight large cupboards. In each study, subjects performed a free search followed by a logical search. In free search, the child was instructed to search the eight locations to find a missing item. In logical search a critical search area within the eight locations was defined for the child on the basis of (a) where the item was last seen and (b) where it was first discovered missing. In free search, more older than younger subjects searched each location at least once and searched all locations sequentially. Detailed comparisons of search patterns under the free and logical conditions revealed that older subjects understood the critical search area. In contrast, younger subjects' searches under the logical condition depended on one salient association of a location with the missing item. The developmental trends indicate that a number of memory and logical processes determine search procedures. The development and integration of these processes are discussed.
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