Norman A. Krasnegor National Institutes of Health
Health compliance research has been a field of interest for the past two decades. A major focus of the investigations carried out was on adults in connection with treatment received for heart disease ( Haynes, Taylor, & Sackett, 1979). The classic definition of compliance was composed by Haynes ( 1979). He said that compliance reflects "the extent to which a person's behavior coincides with medical or health advice" (pp. 1-2). Ewart (this volume) points out, however, that compliance has at least three meanings. These are (a) the behavior(s) that is the goal of intervention, (b) a process through which behavior is changed, and (c) a behavioral product of the context in which behavioral change processes operate. This view provides a more complex picture of compliance in comparison with the definition articulated earlier by Haynes. A most recent conceptualization of compliance indicates that it is a multidimensional construct (see Johnson, this volume). This recognition has important implications for the measurement of compliance.
Whereas in the late 1970s and early 1980s health compliance research on adults represented a vigorous field of study, a marked decline of interest on the topic set in during the last part of the 1980s. By contrast, research on health compliance involving pediatric populations was less popular during the same period; however, interest on this topic is on the increase as evidenced by the contributions to this volume (for an historical perspective, see the chapter by Dunbar et al.).
Four main themes emerge from the chapters contained in this volume and are interwoven among them. They relate to theory, measurement, prevention, and intervention. These themes help to bind and unify the book into a conceptual whole. Although the sections are divided along these thematic lines, the reader