Abstract
Since 1953, the American Heart Association has promoted the concept of prophylaxis for rheumatic fever.' This recommendation is supported by a fund of evidence which indicates that continuous anti-streptococcal prophylaxis can and does prevent recurrent attacks of rheumatic fever. In addition, chemoprophylaxis serves to minimize the likelihood of progressive heart damage.2 Despite the demonstrated value of this type of preventive medication, it has become apparent that a significant proportion of the country's rheumatic fever patients are not maintaining effective continuous p r o p h y laxis.3 Since this issue is of special concern to the United States Public Health Service, the Heart Disease Control Program initiated an exploratory study of the determinants of this form of preventive health behavior. The study design focused upon individuals who are currently maintaining prophylaxis as well as persons who are not. Special attention was given to those factors which served to differentiate these two groups.
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