This study was conducted as the first part of a longitudinal design to explore how children develop attitudes and beliefs about health and how the attitudes and beliefs ultimately affect their health-related behaviors.

Since relatively little empirical work had been done relative to children's beliefs about health, this study sought to fully explore the phenomenon in order to define it and to identify and describe its properties. An inductive, theory-generating study was designed using the grounded theory method. Thirty interviews were conducted with children 11-13 years of age. Constant comparative analysis of the data generated five core categories:.

1. Antecedent Factors: Ways of knowing about health. Antecedent factors are sources of health information which seem to influence the child's definition of health and his/her performance or non-performance of health-related behaviors. Six sources of information, some with subsets, were discovered in the data.

2. Definition Factors: Ways of defining health. Eight major clusters of definitions were discovered in the data. Health was defined in both positive and negative terms; children defined what health is as well as what health is not. Definitions were congruent with the models of health proposed by Smith (1983), ranging in degree of abstraction from clinical to eudaimonistic.

3. Motivation Factors: Mediating variables. Norms, fear, and the notion of prevention emerged as motivation factors. They share a common role as intervening variables which may mediate the relationship between how children define health and how they act on that definition.

4. Activity Factors: A typology of health-related behaviors. Children often described health in terms of activities or behaviors. Seven subsets of data were subsumed by two higher order categories which reflected either prevention behaviors or promotion behaviors.

5. Creating a Meaning of Health emerged as a core category and the Basic Social Process which integrates the preceeding four categories into a cohesive whole. The process of creating a meaning of health has four stages: (1) selection, (2) interpretation, (3) integration, and (4) evaluation.

The substantive level theory generated by this study provides an organizing framework for data generated by diverse other theoretical bases since it supports and subsumes research based on the Health Belief Model, Locus of Control and Piaget. It also goes beyond existing work by providing a way of explaining data which have not been able to be accounted for within the confines of deductive, theory-testing modes of inquiry.

Reference. Smith, J. A. (1983). The idea of health. New York: Teachers College Press.