The project is focused on a neglected area within children's health services research, the relationship between provider-child-caregiver communication during pediatric asthma visits and treatment adherence. Treatment adherence comprises medication adherence, symptom monitoring, and environmental trigger control. Identification of effective communication strategies is important for future intervention research. Thirty-five physicians and their nurses and 360 English-speaking child-caregiver pairs will be recruited at eight pediatric clinics. Children will be eligible if they are between 8 and 15 years of age, have mild, moderate, or severe persistent asthma and have previously visited this clinic at least once before for asthma. Caregivers will be eligible if they are at least 18 years of age and live with the child with asthma. Consent and assent to participate will be obtained from the caregivers and children respectively. Physicians and nurses will fill out a demographic questionnaire at the start of the study. Following enrollment into the study, the children will have their medical visits audio-taped. The children will be interviewed after their medical visits, asked to demonstrate inhaler and peak flow technique, and assessment of their lung function will occur using spirometry. The children's caregivers will fill out questionnaires after these medical visits. A home visit will occur one month after the audio-taped visit. Children will be interviewed during the home visits, asked to demonstrate inhaler and peak flow technique a second time, and have their lung function examined using spirometry. Caregivers will fill out questionnaires. Generalized estimating equations will be used to examine how physician and nurse communication about asthma management, modeling of asthma care behaviors, and engagement of the child and caregiver during medical visits, are related to treatment adherence.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
1R01HL069837-01A2
Application #
6983297
Study Section
Behavioral Medicine, Interventions and Outcomes Study Section (BMIO)
Program Officer
Smith, Robert A
Project Start
2005-08-01
Project End
2009-07-31
Budget Start
2005-08-01
Budget End
2006-07-31
Support Year
1
Fiscal Year
2005
Total Cost
$407,582
Indirect Cost
Name
University of North Carolina Chapel Hill
Department
Pharmacology
Type
Schools of Pharmacy
DUNS #
608195277
City
Chapel Hill
State
NC
Country
United States
Zip Code
27599
Sleath, Betsy; Sulzer, Sandra H; Carpenter, Delesha M et al. (2014) Communication about ADHD and its treatment during pediatric asthma visits. Community Ment Health J 50:185-92
Ayala, Guadalupe X; Gillette, Chris; Williams, Dennis et al. (2014) A prospective examination of asthma symptom monitoring: provider, caregiver and pediatric patient influences on peak flow meter use. J Asthma 51:84-90
Carpenter, Delesha M; Stover, Angela; Slota, Catherine et al. (2014) An evaluation of physicians' engagement of children with asthma in treatment-related discussions. J Child Health Care 18:261-74
Sleath, Betsy; Carpenter, Delesha M; Beard, Ashley et al. (2014) Child and caregiver reported problems in using asthma medications and question-asking during paediatric asthma visits. Int J Pharm Pract 22:69-75
Gillette, Chris; Carpenter, Delesha M; Ayala, Guadalupe X et al. (2013) How often do providers discuss asthma action plans with children? Analysis of transcripts of medical visits. Clin Pediatr (Phila) 52:1161-7
Carpenter, Delesha M; Ayala, Guadalupe X; Williams, Dennis M et al. (2013) The relationship between patient-provider communication and quality of life for children with asthma and their caregivers. J Asthma 50:791-8
Sleath, Betsy; Carpenter, Delesha M; Slota, Catherine et al. (2012) Communication during pediatric asthma visits and self-reported asthma medication adherence. Pediatrics 130:627-33
Washington, Deidre; Yeatts, Karin; Sleath, Betsy et al. (2012) Communication and education about triggers and environmental control strategies during pediatric asthma visits. Patient Educ Couns 86:63-9
Sleath, Betsy; Carpenter, Delesha M; Ayala, Guadalupe X et al. (2012) Communication during pediatric asthma visits and child asthma medication device technique 1 month later. J Asthma 49:918-25
Sleath, Betsy L; Carpenter, Delesha M; Sayner, Robyn et al. (2011) Child and caregiver involvement and shared decision-making during asthma pediatric visits. J Asthma 48:1022-31

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