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Journal of Pediatric Psychology, Vol. 28, No. 8, 2003, pp. 547-558
© 2003 Society of Pediatric Psychology

Children's Primary Health Care Services: Social-Cognitive Factors Related to Utilization

David M. Janicke, PhD1 and Jack W. Finney, PhD2

1 Department of Clinical and Health Psychology, University of Florida, 2 Virginia Polytechnic Institute and State University

All correspondence concerning this article should be addressed to David M. Janicke, Division of Psychology, Cincinnati Childrens's Hospital Medical Center, Sabin Educational Center, 333 Burnet Avenue, Cincinnati, Ohio 45229–3039. E-mail: david.janicke{at}chmcc.org.

Objective To test social-cognitive influences on parent decision-making processes related to children's health care use. Methods Eighty-seven primary caretakers of children ages 4 to 9 years completed measures of child health and behavior, parent functioning, and social-cognitive factors related to parenting and health care use. Primary care use was obtained from the children's primary care physician(s) for the 2 years prior to recruitment. Results Social-cognitive variables accounted for 13.2% of the variance in primary health care use, above and beyond the influence of child health status and psychosocial variables. The best predictive model, accounting for 29.8% of the variance in primary care use, included the interaction between parental stress and self-efficacy to cope with parenting demands, child behavior problems, self-efficacy for accessing physician assistance, medication use, and parent health care use. Conclusions Results documented the relationship between self-efficacy and parent stress in decision making about pediatric primary care use. Social-cognitive theory provides a new perspective for evaluating factors that influence health care use.

Key words: utilization; health care; primary care; children.


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