Abstract
To present common language for defining adherence of infrequent yet repeated health behaviors. We illustrate methodological and conceptual issues using human papillomavirus (HPV) vaccination and screening mammography study data as examples. Adherence rates of infrequent, repeated behaviors varied widely depending on how adherence was defined and measured. We advocate use of 3 standard definitions of adherence: initiation of behavior (initiation), adherence to most recent opportunity (on-schedule), and timely adherence across multiple opportunities (maintenance or completion). The proposed framework has cross-cutting implications for research and practice. Standardizing adherence metrics may facilitate comparisons across studies of health behaviors practiced at infrequent yet repeated intervals.
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