ABSTRACT
Debates about compliance—what to call it and how to improve it—often manifest deeper contests between competing notions of health and illness. In this chapter I approach the question of behavioral compliance from a social action or problem-solving perspective in which health, defined as an organism’s capacity for self-protective action, is distinguished from wellness, defined as the absence of disease. I maintain that compliance, properly understood, refers to a process through which people develop and enhance their capacity for self-protective activity. Confusion has arisen because compliance can—and must—be viewed simultaneously as a desired habit or action state that is the goal of behavioral intervention, a change process through which habits are altered, and a behavioral product of contexts in which habit-change processes operate. A tripartite view of compliance suggests new hypotheses and experiments to advance our understanding of health behavior change in children and generates guidelines for enhancing the long-term impact of health promotion efforts (Ewart, 1991).
