title: Adherence to preventive recommendations: experience of a cohort presenting for executive health care.
abstract: Adherence to recommended preventive services and immunizations in adults is suboptimal and often associated with socioeconomic status, race, and access to care. The aim of this study is to evaluate adherence in a cohort without these barriers to ascertain realistically optimal adherence rates and to examine remaining barriers among relatively advantaged individuals. Specifically, it employed a sample of 6889 patients presenting for executive health care from 2005 to 2009. Adherence varied across colorectal cancer screening (79%), mammography (89%), cervical cancer screening (91%), tetanus immunization (82%), and pneumococcal vaccination (62%). Multivariate logistic regressions revealed that age, education, alcohol use concerns, and being married were positively associated with adherence to certain services. Individuals without the usual barriers to care have variable, less-than-ideal rates of adherence to preventive services, which correlate with some health behaviors and demographics. Understanding the predictors of adherence may inform quality improvement processes aimed at optimizing disease prevention.
authors.affiliation: Division of Health Care Policy and Research, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. shippee.nathan@mayo.edu
authors.forename: Nathan D
authors.initials: ND
authors.lastname: Shippee
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Mullan
authors.forename: Mohammed
authors.initials: M
authors.lastname: Nabhan
authors.forename: Cindy A
authors.initials: CA
authors.lastname: Kermott
authors.forename: Philip T
authors.initials: PT
authors.lastname: Hagen
authors.forename: Deborah J
authors.initials: DJ
authors.lastname: Rhodes
authors.forename: Victor M
authors.initials: VM
authors.lastname: Montori
authors.forename: M Hassan
authors.initials: MH
authors.lastname: Murad
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000428:Alcohol Drinking; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000517:prevention & control; D004522:Educational Status; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008327:Mammography / Q000706:statistics & numerical data; D008393:Marriage; D008403:Mass Screening / Q000706:statistics & numerical data; D008875:Middle Aged; D010349:Patient Compliance; D022242:Pneumococcal Vaccines / Q000008:administration & dosage; D011314:Preventive Health Services / Q000706:statistics & numerical data*; D013745:Tetanus Toxoid / Q000008:administration & dosage; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control
chemical_list: D022242:Pneumococcal Vaccines; D013745:Tetanus Toxoid