Standard definitions of adherence for infrequent yet repeated health behaviors

Am J Health Behav. Nov-Dec 2010;34(6):669-79. doi: 10.5993/ajhb.34.6.4.


Objective: To present common language for defining adherence of infrequent yet repeated health behaviors.

Methods: We illustrate methodological and conceptual issues using human papillomavirus (HPV) vaccination and screening mammography study data as examples.

Results: Adherence rates of infrequent, repeated behaviors varied widely depending on how adherence was defined and measured. We advocate use of 3 standard definitions of adherence: initiation of behavior (initiation), adherence to most recent opportunity (on-schedule), and timely adherence across multiple opportunities (maintenance or completion).

Conclusions: The proposed framework has cross-cutting implications for research and practice. Standardizing adherence metrics may facilitate comparisons across studies of health behaviors practiced at infrequent yet repeated intervals.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Female
  • Health Behavior*
  • Humans
  • Mammography / psychology
  • Outcome Assessment, Health Care / standards*
  • Patient Compliance / psychology
  • Patient Compliance / statistics & numerical data*
  • Vaccination / psychology