Abstract
This paper explores the components and determinants of health attitudes that have accompanied the process of modernization in Accra. Due to the numerous failures to predict behavior from unidimensional measures of attitudes, a multidimensional approach to health attitudes was used. Factor analysis of the components revealed that this multidimensional tripartite structure of health attitudes is theoretically meaningful. Both the simple correlational and multivariate analysis of responses form a sample interview survey of 1000 women show that social, structural and community factors are important determinants of modern health attitudes; and that the influence of modern health attitudes on utilization behavior is independent of the effects of education and general modernity. The implications of these for health care delivery are discussed.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Aday, L. A. and Anderson, R. M.: 1974, ‘A framework for the study of access to medical care’, Health Services Research 9, 208–220.
Ajzen, I. and Fishbein, M.: 1980, ‘Attitudes’, in C. A. Murchison (ed), A Handbook of Social Psychology (Clark University Press, Worcester), pp. 798–884.
Andersen, R., Davies, J. K., Kickbusch, I., McQueen, D. V., and Turner, J.: 1988, Health behaviour Research and Health Promotion (Oxford University Press, New York).
Andersen, R. M.: 1968, ‘A Behavioral model of families' use of health services’, Research Series, 25, Center for Health Administration Studies Chicago: University of Chicago.
Andersen, R. M. and Newman, J. F.: 1973, ‘Societal and individual determinants of medical care utilization in the United States’, Milbank Memorial Quarterly 51, 95–124.
Bagozzi, R. P. and Youjae, Y.: 1989, ‘The degree of intention formation as a moderator of the attitude-behavior relationship’, Social Psychology Quarterly 52(4), 266–279.
Becker, M. H. and Rosenstock, I. M.: 1989, ‘Health promotion disease prevention, and program retention’, in Handbook of Medical Sociology (3rd edition) pp. 284–405.
Black, C.: 1966, The Dynamics of Modernization (Harper & Row, New York).
Culbertson, H. M. and Stempel, G. H.: 1985, ‘Media malaise: explaining personal optimism and societal pessimism about health care’, Jr. of Communication 35(2), 180–190.
Downie, R. S., Fyfe, C., and Tannahil, A.: 1990, Health Promotion: Models and Values (Oxford University Press, New York).
Feldman, R. H. L. and Hollander, R. B.: 1983, ‘Issues in cross-cultural and international health education research’, Health Education 14, 11–15.
Fishbein, M.: 1967, ‘A consideration of beliefs and their role in attitude measurement’, in M. Fishbein (ed), Readings in Attitude Theory and Measurement, pp. 257–266.
Fosu, G. B.: 1986, ‘Implications of mortality and morbidity for health care delivery in Ghana’, Sociology of Health and Illness 8(3), 252–277.
Fosu, G. B.: 1988, ‘Integrating population programs into health services: lessons from Urban Ghana’, African Urban Quarterly 3 (Nos. 3 and 4), 238–251.
Fosu, G. B.: 1989, ‘Access to health care in urban areas of developing societies’, Jr. of Health and Social Behavior 30, 398–411.
Fosu, G. B.: 1991, ‘Maternal influences on preventive health behavior in children’, Int'l. Quarterly of Community Health Education 12(1), 1–19.
Fredericks, A. J. and Dosset, D. L.: 1983, ‘Attitude-behavior relations: A comparison of Fishbein-Aizen and Bentler-Speckart models’, Jr. of Personality and Social Psychology 45, 501–512.
Glanz, K., Lewis, F. M., and Rimer, B. K. (eds): 1990, Health Behavior and Health Education: Theory Research and Practice (Jossey-Bass, San Francisco).
Gochman, D. S.: 1988, Health Behavior: Emerging Research Perspective (Plenum Press, New York).
Goldscheider, C.: 1971. Population, Modernization and Social Structure (Little, Brown & Co., Boston).
Green, L. W.: 1970, ‘Should health education abandon attitude change strategies: perspectives from recent research’, Health Education Monograph 30, 26–47.
Guttman, L. A.: 1944, ‘A basis for scaling quantitative data’, American Sociological Review 9, 139–150.
Harman, H. H.: 1976, Modern Factor Analysis (University of Chicago Press, Chicago).
Inkeles, A. and Smith, D. H.: 1983, Becoming Modern: Individual Change in Six Developing Countries (Harvard University Press, Cambridge).
Jaccard, J.: 1975 ‘A theoretical analysis of selected factors important to health education strategies’, Health Education Monographs 3, 152–166.
Kim, J. and Mueller, C.: 1978, Introduction to Factor Analysis (Sage Publications, Beverly Hills).
Kish, L.: 1965, Survey Sampling, John Wiley and Sons, N.Y. See also Kish ‘Sampling methods’, in International Encyclopedia of Population (McGraw-Hill, New York) 1982, pp. 601–605.
Kothandapani, V.: 1971, ‘Validation of feeling, belief, and intention to act as three components of attitude and their contribution to prediction of contraceptive behavior’, Journal of Personality and Social Psychology 19, 321–333.
Leigh, J. P.: 1983, ‘Direct and indirect effects of education on health, Social Science & Medicine 17(4), 227–234.
Liska, A. E.: 1984, ‘A critical examination of the causal structure of the Fishbein-Aizen model’, Social Psychology Quarterly 47, 61–74.
Lucas, D. and Ware, H.: 1977, ‘Language differences and the family planning survey’, Studies in Family Planning 8(9), 233–236.
Maiman, L. A. and Becker, M. H.: 1974, ‘The health belief model: origins and correlates in psychological theory’, Health Education Monographs 2, 336–353.
Mechanic, D.: 1979, ‘Correlates of physician utilization: why do major multivariate studies of physician utilization find trivial psychosocial or organizational effects?’, Journal of Health and Social Behavior 20, 387–396.
McKinlay, J. B. and McKinlay, S. M.: 1977, ‘The questionable contribution of medical measures to the decline of mortality in the United States in the twentieth century’, Milbank Memorial Fund Quarterly/Health and Society 55(3), 405–428.
Moore, W.: 1965, The Impact of Industry (Prentice-Hall, New York).
Muller, Daniel J.: 1986, Measuring Social Attitudes (Teachers College Press, N.Y.).
Ostrom, T. M.: 1969, ‘The relationship between the affective, behavioral and cognitive components of attitude’, Journal of Experimental Social Psychology 5, 12–20.
Ribeaux, S. and Poppleton, S. E.: 1978, Psychology and Work — An Introduction (MacMillan, London).
Rueschemeyer, D.: 1976, ‘Partial modernization’, in J. J. Loubseret al. (ed), Explorations in General Theory in the Social Sciences (The Free Press, New York), pp. 756–772.
Rummel, R. J.: 1970, Applied Factor Analysis (Northwestern University Press, Evanstan).
Scarpaci, J. L.: 1988, ‘Help-seeking behavior, use, and satisfaction among frequent primary care users in Santiago de Chile’, Journal of Health and Social Behavior 29: 199–213.
Snow, J.: 1855, On the Mode of Communication of Cholera (2nd ed.), Churchill, London Reproduced in Snow on Cholera, Commonwealth Fund, New York, 1936. Reprinted by Hafner, N.Y. 1965.
Suchman, E. A.: 1966, ‘Health orientation and medical care’, American Jr. of Public Health 56, 97–105.
Twumasi, P. A.: 1975, Medical Systems in Ghana (Ghana Publishing Corporation, Tema).
Twumasi, P. A.: 1976, ‘The working day of a Ghanaian woman trader’, Social and Economic Review 3(7), 6–13.
Wan, T. H. and Arling, C.: 1982, ‘Use of health service by the elderly in low income communities’, Milbank Memorial Fund Quarterly 60, 82–107.
Warshaw, P. R. and Davis, F. D.: 1985, ‘Disentangling behavioral intention and behavioral expectation’, Journal of Experimental Social Psychology 21, 213–228.
Werner, P. D.: 1977, ‘Implications of attitude — behavior studies for population research and action’, Studies in Family Planning 8, No. 11, 294–298.
Wolinsky, F. D.: 1978, ‘Assessing the effects of predisposing, enabling, and illnessmorbidity characteristics on health service utilization’, Journal of Health and Social Behavior 19, 3843–3896.
World Bank: 1980, Health Sector Policy Paper, Washington, D.C.
Author information
Authors and Affiliations
Additional information
Funding for the data collection was provided by the Rockefeller and Ford Foundations (RF81028 # 174), The Population Studies Center of Brown University, and the University of Ghana. The author acknowledges the secretarial help of Pat Richardson.
Rights and permissions
About this article
Cite this article
Fosu, G.B. Indicators of modern health attitudes in an urban setting: An exploration of the attitude — Behavior relationship. Soc Indic Res 28, 45–70 (1993). https://doi.org/10.1007/BF01086716
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01086716