The main goal of this 2-year pilot project (in response to PA 03-159) is to apply the Children's Health Belief Model (CHBM) to predict self-management behaviors in children age 6-13 years of age with sickle cell disease (SCO). As these children grow older, they become increasingly more responsible for the management of their disease. This may involve both preventative actions and medications. Models to predict medical self-management and adherence outcome in children have largely focused on specific environmental and psychosocial factors (such as motivation, perceived threat, risk-taking behavior, socioeconomic status, etc.), but have not used a more complete modeling of these factors in combination to specifically address children with chronic medical illness, including SCO Furthermore, no models thus far have included a neurocognitive component, often an important consideration in chronic illnesses that may result in compromise of central nervous system functioning. Although the CHBM has been used to predict medication use in children with common, minor ailments, it has never been applied to a chronic pediatric illness. In addition to applying this health belief model, we propose to include a neurocognitive factor to account for varying degrees of CMS compromise demonstrated in children with SCO. The neurocognitive factor will consist of measures of prospective memory (remembering to perform actions in the future) and sustained attention (vigilance) as these cognitive processes are hypothesized to be important in performing self-management behaviors. The plan is to test the addition of this neurocognitive factor to a subsection of the full CHBM including only the statistically significant major pathways found to be important in medication use (which is a subset of self-management behaviors). We hypothesize that the subsection of the causal model will account for a significant portion of the variance in self-management behaviors. Further, the addition of the neurocognitive factor (primarily focusing on prospective memory) will significantly improve the variance accounted for in self-management. These data will allow for the testing of the full CHBM model in a future study with a larger sample of children with SCO, and provide guidance as to which pathways would be most amenable to intervention directed at improving self-management behaviors, and ultimately improving the quality of life for children with SCO. Relevance: This project will help identify behaviors, mental abilities, and beliefs that contribute to how well a child performs SCO self-manage behaviors to maintain optimal health. The model being tested will help identify areas (behaviors and health beliefs) that could be targeted through intervention programs to help children self-manage their SCO more effectively to maintain optimal health. ? ?
| McCauley, Stephen R; Pedroza, Claudia (2010) Event-based prospective memory in children with sickle cell disease: effect of cue distinctiveness. Child Neuropsychol 16:293-312 |
