DEFINITION OF COMPLIANCE AND OVERVIEW OF HEALTH COMPLIANCE RESEARCH
Norman A. Krasnegor
This section of the book contains two chapters that, respectively, address issues related to defining compliance and providing a perspective on health compliance research carried out in the 1970s and 1980s.
Chapter 1 by Paul Karoly, "Enlarging the Scope of the Compliance Construct: Toward Developmental and Motivational Relevance," has as its focus the analysis of health compliance as a construct. Karoly suggests that compliance is usually defined as a technical problem that is atheoretical in nature; that is to say, compliance is a problem associated with getting the patient to behave in accord with medical advice. He finds this definition to be somewhat sterile and urges that compliance should be thought of as a construct not unlike intelligence.
Karoly argues that control theory offers a useful meta-analytic framework for conceptualizing the construct. The power of this approach is that it offers the possibility of combining cause-effect models and those that attempt to analyze "properties of people and/or systems (e.g., families) that are capable of yielding consistencies in health maintaining behavior." Karoly offers a triarchic model of compliance that is analogous to Sternberg's model of the construct of intelligence. The three levels of explanation are, respectively, the componential, the contextual, and the experiential.