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Open Access Highly Accessed Open Badges Research article

Measuring factors that influence the utilisation of preventive care services provided by general practitioners in Australia

Jianzhen Zhang1*, Brian Oldenburg2 and Gavin Turrell3

Author Affiliations

1 School of Medicine, University of Queensland, Herston Road, Herston, Brisbane QLD 4006, Australia

2 School of Public Health and Preventive Medicine, Monash University, Victoria, Australia

3 School of Public Health, Queensland University of Technology, Queensland, Australia

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BMC Health Services Research 2009, 9:218  doi:10.1186/1472-6963-9-218

Published: 3 December 2009



Relatively little research attention has been given to the development of standardised and psychometrically sound scales for measuring influences relevant to the utilisation of health services. This study aims to describe the development, validation and internal reliability of some existing and new scales to measure factors that are likely to influence utilisation of preventive care services provided by general practitioners in Australia.


Relevant domains of influence were first identified from a literature review and formative research. Items were then generated by using and adapting previously developed scales and published findings from these. The new items and scales were pre-tested and qualitative feedback was obtained from a convenience sample of citizens from the community and a panel of experts. Principal Components Analyses (PCA) and internal reliability testing (Cronbach's alpha) were then conducted for all of the newly adapted or developed scales utilising data collected from a self-administered mailed survey sent to a randomly selected population-based sample of 381 individuals (response rate 65.6 per cent).


The PCA identified five scales with acceptable levels of internal consistency were: (1) social support (ten items), alpha 0.86; (2) perceived interpersonal care (five items), alpha 0.87, (3) concerns about availability of health care and accessibility to health care (eight items), alpha 0.80, (4) value of good health (five items), alpha 0.79, and (5) attitudes towards health care (three items), alpha 0.75.


The five scales are suitable for further development and more widespread use in research aimed at understanding the determinants of preventive health services utilisation among adults in the general population.