Client-professional interaction and level of participation in preventive health screenings in community-dwelling African American older adults : testing a middle-range theory derived from Cox's Interaction Model of Client Health Behavior (IMCHB)

The purpose of this study was to test a middle-range Theory of Level of Participation in Preventive Health Screening among Community-dwelling African American Older Adults derived from Cox's (1982) Interaction Model of Client Health Behavior. This descriptive correlational study described the variables related to level of participation in health screenings of older African Americans living in the community and determined if a significant relationship existed between satisfying and effective client/professional interaction and level of participation in health screenings in African American older adults. The sample was obtained from the Medical Expenditure Panel Survey conducted by the Agency for Health Care Research and Quality to provide nationally representative estimates of health care expenditure, insurance coverage, payment sources, and service utilization. The sample consisted of 266 African American older adults, (99 men, 167 women), 65 years of age and older, with a range of 65 to 90 years of age and a mean age of 73. Using Cox's Model, background variables in this study were, age, sex, education, marital status, poverty status, and insurance coverage. No significant relationships were found among the background variables and level of participation in preventive health screenings. Cognitive appraisal was operationalized by measures of general health and mental health perception. Surprisingly, multiple linear regression revealed that clients with excellent perception of health have lower level of participation in preventive health screenings (B=-1.46, p=0.0023). As predicted by the theory, participants with higher levels of satisfaction with client-professional were found to have higher level of participation in preventive health screenings (B=0.35, p=0.0137). In a regression model combining background variables, cognitive appraisal variables, and client-professional interaction, only client-professional interaction was significantly related to level of participation in preventive health screenings (B=0.36, p=0.0100). A surprising finding was that there was no difference between men and women in level of participation in preventive health screenings.