Noncompliance with medication regimens is a prevalent problem for pediatric asthma patients, particularly within the preadolescent and adolescent age range. The proposed study will investigate the effectiveness of an intervention aimed at promoting parent-youth partnership in managing asthma. Forty-five patients (ages 9-13 years) with asthma will be randomly assigned to one of three groups: Teamwork Intervention (TI), Attention Control (AC), or Standard Core (SC). TI and AC groups will receive four, 30-minute, office-based treatment sessions in a pediatric asthma and allergy clinic. These visits will be scheduled approximately once a month for four (4) months, with follow-up data being gathered approximately 6-months following the last treatment visit. The TI intervention is the focus of the study and will consist of strategies (e.g., realistic expectations, positive communication, negotiation and contracting) used in Robin and Foster's (1989) behavioral-family systems model of family functioning. These strategies, however, will be addressing directly the parent-youth partnership in asthma management. Additionally, basic principles of """"""""promoting and fading,"""""""" a behavior modification procedure, will be used to structure the systematic process by which youth will be encouraged to adhere to medication in an increasingly independent manner. In contrast, the AC group will receive structured reviews of asthma educational materials typically given to this patient population. SC participants, on the other hand, will have no contact with the research team beyond that necessary to gather data. Outcome data will include objective measures of medication adherence, parental involvement in asthma management, parent-adolescent conflict, and health outcome (e.g., lung functioning). It is hypothesized that when compared to the AC and SC participants, TI families will have greater adherence to medication use, increased parental involvement in the child's asthma management tasks, non-clinical levels of parent-adolescent conflict, and better patients' health outcome. Results are anticipated to assist health care providers in understanding how to use an office-based intervention, which requires little time and effort, to encourage parental involvement and parent-youth teamwork in the management of children's asthma.
| Duncan, Christina L; Hogan, Mary Beth; Tien, Karen J et al. (2013) Efficacy of a parent-youth teamwork intervention to promote adherence in pediatric asthma. J Pediatr Psychol 38:617-28 |
