Date of Award

Spring 1992

Document Type


Degree Name

Doctor of Philosophy (PhD)


Urban Services - Urban Education

Committee Director

Maurice R. Berube

Committee Member

Gregory H. Frazer

Committee Member

Beverly B. Johnson

Committee Member

Robert Lucking

Committee Member

Donald A. Myers


The purpose of this study was two fold: 1) to investigate the effects that level of educational attainment and income have on the health behaviors of an urban population, and 2) to examine the effects the level of motivation and selected demographic characteristics (e.g., age, race, gender) have on the study sample's perceived satisfaction with the medical encounter. Based on the findings of the study, a model community health education program was proposed. The study sample was comprised of 150 volunteers seeking health care for chronic conditions at a family practice clinic. The Krantz Health Opinion Survey (HOS) measured the two dependent variables of active behavioral involvement and desire to be medically informed (Krantz, Baum & Wideman, 1980). Motivation was measured by the Cox Self-Determinism Index (HSDI)(Cox, 1985). The Smith-Falvo Patient-Doctor Interaction Survey (PDSI) was used to measure patient's satisfaction with their medical encounter (Smith, Falvo, McKillip & Pitz, 1984) . Sixty-two of the volunteers agreed to be videotaped during their medical interviews so their medical interactions could be analyzed using the Multidimensional Interaction Analysis (MDIA) instrument (Greene, Adelman & Charon, 1991).

Data analysis revealed the study sample had a mean age of 59.2 years, with a greater number of Caucasian, middle class, females as volunteers. Chi-Square tests reported that the desire to be medically informed was positively contingent with the level of educational attainment [X2(2, N = 150) = 9.052, p=.011]. The level of patient satisfaction was positively contingent with the group's level of educational attainment [Xz(2, N = 150) = 18.43, pc.001]. A positive trend of contingency was reported between the group's level of income and their active behavioral involvement, as analyzed from the videotapes [X2(l, n = 62) = 3.337, p=.068]. Multiple regression equations were developed to predict subject's active behavioral involvement, level of satisfaction with health care, and desire to be medically informed. A factor analysis was created to develop a theoretical model which could be used for explaining health seeking behaviors of larger populations. Total motivation in health seeking, perceived health judgement, and internal versus external cue responsiveness comprised the variables loading on the Health Care Decision Making factor. The Health Inquiry factor was created from the Krantz HOS total score and the Desire to Be Medically Informed score.

Based on the findings reported, a community health education program was proposed that emphasized local community involvement and clearly defined goals for curriculum development. A blueprint for program curricular development was presented incorporating the elements of resource identification, establishing terminal objectives for measurement and reassessing program success based on outcome.