Background: Religious/spiritual coping, that is, how individuals use religion/spirituality to deal with a stressor like a chronic illness, has been associated with improved physical and psychological outcomes in adults, but little is known about religious/spiritual coping in adolescents with a chronic illness, such as asthma. Objectives: As a clinical health psychologist interested in spirituality and coping in adolescents with chronic illness, the specific objectives for this award are to: a) enhance my skills in measurement development and research methodology to assess effectively the relationships between religious/spiritual factors and health outcomes for adolescents, b) validate 2 widely-used adult spirituality measures for use in adolescents, and c) develop and pilot test a spiritually-based intervention to assess feasibility of use in adolescents with a chronic illness. Training: For my career development, I plan to take further training in specific qualitative and quantitative methods, data analysis, and manuscript/grant preparation. Training activities will also include coursework, mentored secondary data analyses, and clinical work. My mentorship team is comprised of leading experts in the fields of spirituality, health-related quality of life, adolescent medicine, chronic illness, and research methodology: Joel Tsevat, MD, MPH (primary co-sponsor), Susan Rosenthal, PhD (co-sponsor), Maria Britto, MD, MPH, Kenneth Pargament, PhD, and Paul Succop, PhD. Research Design/Methods: The research plan consists of 3 projects involving a total of 165 adolescent outpatients with asthma. Project 1 is a qualitative study with 25 adolescents using semi-structured interviews to determine: a) whether 2 widely-used adult spirituality measures are understandable by adolescents, b) the range and depth of religious/spiritual coping strategies used, and c) why adolescents use religious/spiritual coping strategies. Project 2 is a quantitative prospective study with 115 adolescents using questionnaires to: a) assess the psychometric properties of 2 adult spirituality measures utilizing exploratory factor analysis and other statistical techniques, and b) examine the cross-sectional and longitudinal relationships among religiosity/spirituality, religious/spiritual coping, and health outcomes (i.e., health-related quality of life, depression/anxiety), and use structural equation modeling to assess moderating variables (e.g., developmental stage/age) and potential mediating pathways (e.g., social support). Project 3 is a pilot feasibility study with 25 adolescents to examine whether a spiritually-based intervention developed from findings from Projects 1 and 2 is feasible for use in adolescents with asthma. Findings will inform an R01 application of a longitudinal randomized controlled trial comparing a spiritually-based intervention versus a standard psychosocial intervention to improve health outcomes in adolescents with chronic illness.

National Institute of Health (NIH)
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Mentored Patient-Oriented Research Career Development Award (K23)
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Study Section
Pediatrics Subcommittee (CHHD)
Program Officer
Haverkos, Lynne
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University of Cincinnati
Family Medicine
Schools of Medicine
United States
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Cotton, Sian; Grossoehme, Daniel H; Bignall, Whitney R et al. (2014) Should my provider pray with me? Perspectives of urban adolescents with asthma on addressing religious and spiritual issues in hypothetical clinical settings. J Relig Health 53:604-13
Grossoehme, Daniel H; Cotton, Sian; Ragsdale, Judy et al. (2013) ""I honestly believe god keeps me healthy so i can take care of my child"": parental use of faith related to treatment adherence. J Health Care Chaplain 19:66-78
Grossoehme, Daniel H; Cotton, Sian; McPhail, Gary (2013) Use and sanctification of complementary and alternative medicine by parents of children with cystic fibrosis. J Health Care Chaplain 19:22-32
Cotton, Sian; Grossoehme, Daniel; McGrady, Meghan E (2012) Religious coping and the use of prayer in children with sickle cell disease. Pediatr Blood Cancer 58:244-9
Cotton, Sian; Weekes, Jerren C; McGrady, Meghan E et al. (2012) Spirituality and religiosity in urban adolescents with asthma. J Relig Health 51:118-31
Grossoehme, Daniel H; Ragsdale, Judith R; Cotton, Sian et al. (2012) Using spirituality after an adult CF diagnosis: cognitive reframing and adherence motivation. J Health Care Chaplain 18:110-20
Luberto, Christina M; Yi, Michael S; Tsevat, Joel et al. (2012) Complementary and alternative medicine use and psychosocial outcomes among urban adolescents with asthma. J Asthma 49:409-15
Kudel, Ian; Cotton, Sian; Szaflarski, Magda et al. (2011) Spirituality and religiosity in patients with HIV: a test and expansion of a model. Ann Behav Med 41:92-103
Weekes, Jerren C; Cotton, Sian; McGrady, Meghan E (2011) Predictors of substance use among black urban adolescents with asthma: a longitudinal assessment. J Natl Med Assoc 103:392-8
Cotton, Sian; Humenay Roberts, Yvonne; Tsevat, Joel et al. (2010) Mind-body complementary alternative medicine use and quality of life in adolescents with inflammatory bowel disease. Inflamm Bowel Dis 16:501-6

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