ASTHMA MANAGEMENT AND ETHNIC DISPARITIES AT THE ADOLESCENT TRANSITION
Elizabeth L Mcquaid, Associate Professor Of Psychiatry (resea
Rhode Island Hospital, Providence, Ri 02903-4923
Grant 1K24HD058794-01A1 from Eunice Kennedy Shriver National Institute Of Child Health & Human Development
Abstract: This revised K24 application proposes a mentorship program in patient-oriented research in pediatric asthma, with a specific focus on health care disparities and disease management behaviors. The K24 Candidate is an Associate Professor (Research) in the Department of Psychiatry and Human Behavior of the Warren Alpert Medical School at Brown University, with a history of funding in behavioral interventions to improve disease management and address health disparities in pediatric asthma. Training Plan The candidate will obtain additional training in longitudinal data analysis, behavioral genetics, evaluation and assessment in health education, and health care access for Latino immigrants to enrich her skills and mentoring capacity in future health care disparities research. Research Plan A longitudinal study of medication adherence for Latinos and non-Latino white (NLW) youth with asthma is proposed to assess the differential course of medication adherence by culture across the transition to adolescence. Three waves of 50 youth with persistent asthma (150 total, 25 Latino, 25 NLW in each wave) will complete a multimethod assessment of asthma status, family factors, medication beliefs, and controller medication use. Assessments will occur in eighth grade, then again in tenth grade, with continuous monitoring of medication adherence throughout. Analyses will evaluate the role of medication beliefs and family connectedness in supporting asthma management in Latino and NLW youth with persistent asthma, and assess differential trajectories of medication use by ethnic group over time. Mentoring Plan The proposed mentoring plan offers participation in an RCT to address asthma disparities in medication use, access to an ongoing educational program for asthma that serves over 700 families a year, and an archival dataset that includes a wealth of data on disease management behavior in over 800 Latino and NLW children in Rl and Puerto Rico. An additional ongoing seminar is planned for junior faculty on topics such as recruiting and retaining culturally diverse samples, and preparing research grant applications. This overall plan capitalizes on the rich resources and training opportunities available to postdoctoral fellows and junior faculty at Brown, including seven T32 fellowship programs, numerous junior faculty with K awards and small grants, seminars in research design, ethics, and statistics, and established infrastructure for evaluation. Public Health Significance Asthma is a common chronic illness in which minority children are disproportionately affected. Facilitating mentorship and execution of high quality patient-oriented research in this area is critical to address health care disparities. PROJECT/
Keywords: 0-11 years old; 12-20 years old; Access to Care; Access to Health Care; Access to Healthcare; Accessibility of health care; Acculturation; Acculturations; Active Follow-up; Address; Adherence; Adherence (attribute); Adolescence; Adolescent; Adolescent Youth; Affect; African American; Afro American; Afroamerican; Analysis, Data; Area; Asthma; Asthma in Children; Availability of Health Services; Behavior; Behavior Conditioning Therapy; Behavior Modification; Behavior Therapy; Behavior Treatment; Behavior or Life Style Modifications; Behavioral Conditioning Therapy; Behavioral Genetics; Behavioral Modification; Behavioral Therapy; Behavioral Treatment; Belief; Black Populations; Black or African American; Bronchial Asthma; Care, Health; Career Development Awards; Career Development Awards and Programs; Career Development Programs K-Series; Child; Child Youth; Childhood; Childhood Asthma; Children (0-21); Chronic Disease; Chronic Illness; Clinical; Complex; Conditioning Therapy; Cultural Assimilation; Data; Data Analyses; Data Set; Dataset; Development; Disease; Disease Management; Disorder; Disorder Management; Drugs; Enrollment; Epidemiology; Ethics; Ethnic Origin; Ethnic and Racial Minorities; Ethnic group; Ethnicity; Ethnicity aspects; Evaluation; Faculty; Family; Fellowship Program; Funding; Future; Genetic Determinants of Behavior; Genetics, Behavioral; Goals; Grant; Health Instruction; Health Services Accessibility; Health Training; Health Tutoring; Health education; Healthcare; History; Human; Human, Child; Human, General; Immigrant; Infrastructure; Intervention; Intervention Strategies; Interview; K-Awards; K-Series Research Career Programs; Latino; Life Style Modification; Longitudinal Studies; Man (Taxonomy); Man, Modern; Mediating; Medication; Mentors; Mentorship; Minority; Minority Groups; Monitor; Morbidity; Morbidity - disease rate; Mortality; Mortality Vital Statistics; Parents; Pattern; Pediatric asthma; Pharmaceutic Preparations; Pharmaceutical Preparations; Play; Postdoc; Postdoctoral Fellow; Process; Programs (PT); Programs [Publication Type]; Protocol; Protocols documentation; Protocols, Treatment; Psychiatry; Public Health; Puerto Rico; R01 Mechanism; R01 Program; RGM; RPG; Randomized Controlled Trials; Recording of previous events; Recruitment Activity; Regimen; Relative; Relative (related person); Research; Research Associate; Research Career Program; Research Career Programs, K-Series; Research Design; Research Grants; Research Infrastructure; Research Project Grants; Research Projects; Research Projects, R-Series; Research Resources; Resources; Role; Sampling; Schools, Medical; Science of Statistics; Statistics; Study Type; Supervision; Testing; Time; Training; Treatment Protocols; Treatment Regimen; Treatment Schedule; Universities; Work; Youth; Youth 10-21; access to services; access to treatment; adolescence (12-20); availability of services; behavior genetics; behavior intervention; behavioral intervention; black American; children; chronic disease/disorder; chronic disorder; disease control; disease/disorder; disorder control; drug/agent; eighth grade; enroll; follow-up; health care availability; health care service access; health care service availability; health disparities; health disparity; health services availability; healthcare access availability; healthcare service access; healthcare service availability; high school; improved; individual responsibility; interest; intervention development; interventional strategy; juvenile; juvenile human; long-term study; medical schools; medication adherence; medication compliance; patient oriented research; patient oriented study; pediatric; post-doc; post-doctoral; professor; programs; prospective; public health medicine (field); public health relevance; randomized controlled study; recruit; skills; social role; statistics; study design; teenage; tenth grade; therapy development; treatment development; youngster
Project start date: 2009-06-15
Project end date: 2014-05-31
Budget start date: 15-JUN-2009
Budget end date: 31-MAY-2010
PFA/PA: PA-08-151
1K24HD058794-01A1 (2009): $109728
Sponsored Links Excellgen http://Excellgen.com
Grants awarded to Elizabeth L Mcquaid
ASTHMA MANAGEMENT AND ETHNIC DISPARITIES AT THE ADOLESCENT TRANSITION
Elizabeth L Mcquaid, Associate Professor Of Psychiatry (resea
Rhode Island Hospital, Providence, Ri 02903-4923
Grant 5K24HD058794-02 from Eunice Kennedy Shriver National Institute Of Child Health & Human Development
Abstract: This revised K24 application proposes a mentorship program in patient-oriented research in pediatric asthma, with a specific focus on health care disparities and disease management behaviors. The K24 Candidate is an Associate Professor (Research) in the Department of Psychiatry and Human Behavior of the Warren Alpert Medical School at Brown University, with a history of funding in behavioral interventions to improve disease management and address health disparities in pediatric asthma. Training Plan The candidate will obtain additional training in longitudinal data analysis, behavioral genetics, evaluation and assessment in health education, and health care access for Latino immigrants to enrich her skills and mentoring capacity in future health care disparities research. Research Plan A longitudinal study of medication adherence for Latinos and non-Latino white (NLW) youth with asthma is proposed to assess the differential course of medication adherence by culture across the transition to adolescence. Three waves of 50 youth with persistent asthma (150 total, 25 Latino, 25 NLW in each wave) will complete a multimethod assessment of asthma status, family factors, medication beliefs, and controller medication use. Assessments will occur in eighth grade, then again in tenth grade, with continuous monitoring of medication adherence throughout. Analyses will evaluate the role of medication beliefs and family connectedness in supporting asthma management in Latino and NLW youth with persistent asthma, and assess differential trajectories of medication use by ethnic group over time. Mentoring Plan The proposed mentoring plan offers participation in an RCT to address asthma disparities in medication use, access to an ongoing educational program for asthma that serves over 700 families a year, and an archival dataset that includes a wealth of data on disease management behavior in over 800 Latino and NLW children in Rl and Puerto Rico. An additional ongoing seminar is planned for junior faculty on topics such as recruiting and retaining culturally diverse samples, and preparing research grant applications. This overall plan capitalizes on the rich resources and training opportunities available to postdoctoral fellows and junior faculty at Brown, including seven T32 fellowship programs, numerous junior faculty with K awards and small grants, seminars in research design, ethics, and statistics, and established infrastructure for evaluation. Public Health Significance Asthma is a common chronic illness in which minority children are disproportionately affected. Facilitating mentorship and execution of high quality patient-oriented research in this area is critical to address health care disparities. PROJECT/
Keywords: 0-11 years old; 12-20 years old; Access to Care; Access to Health Care; Access to Healthcare; Accessibility of health care; Acculturation; Acculturations; Active Follow-up; Address; Adherence; Adherence (attribute); Adolescence; Adolescent; Adolescent Youth; Affect; African American; Afro American; Afroamerican; Analysis, Data; Area; Asthma; Asthma in Children; Availability of Health Services; Behavior; Behavior Conditioning Therapy; Behavior Modification; Behavior Therapy; Behavior Treatment; Behavior or Life Style Modifications; Behavioral Conditioning Therapy; Behavioral Genetics; Behavioral Modification; Behavioral Therapy; Behavioral Treatment; Belief; Black Populations; Black or African American; Bronchial Asthma; Care, Health; Career Development Awards; Career Development Awards and Programs; Career Development Programs K-Series; Child; Child Youth; Childhood; Childhood Asthma; Children (0-21); Chronic Disease; Chronic Illness; Clinical; Complex; Conditioning Therapy; Cultural Assimilation; Data; Data Analyses; Data Set; Dataset; Development; Disease; Disease Management; Disorder; Disorder Management; Drugs; Enrollment; Epidemiology; Ethics; Ethnic Origin; Ethnic and Racial Minorities; Ethnic group; Ethnicity; Ethnicity aspects; Evaluation; Faculty; Family; Fellowship Program; Funding; Future; Genetic Determinants of Behavior; Genetics, Behavioral; Goals; Grant; Health Instruction; Health Services Accessibility; Health Training; Health Tutoring; Health education; Healthcare; History; Human; Human, Child; Human, General; Immigrant; Infrastructure; Intervention; Intervention Strategies; Interview; K-Awards; K-Series Research Career Programs; Latino; Life Style Modification; Longitudinal Studies; Man (Taxonomy); Man, Modern; Mediating; Medication; Mentors; Mentorship; Minority; Minority Groups; Monitor; Morbidity; Morbidity - disease rate; Mortality; Mortality Vital Statistics; Parents; Pattern; Pediatric asthma; Pharmaceutic Preparations; Pharmaceutical Preparations; Play; Postdoc; Postdoctoral Fellow; Process; Programs (PT); Programs [Publication Type]; Protocol; Protocols documentation; Psychiatry; Public Health; Puerto Rico; R01 Mechanism; R01 Program; RPG; Randomized Controlled Trials; Recording of previous events; Recruitment Activity; Regimen; Relative; Relative (related person); Research; Research Associate; Research Career Program; Research Career Programs, K-Series; Research Design; Research Grants; Research Infrastructure; Research Project Grants; Research Projects; Research Projects, R-Series; Research Resources; Resources; Role; Sampling; Science of Statistics; Statistics; Study Type; Supervision; Testing; Time; Training; Universities; Work; Youth; Youth 10-21; access to services; access to treatment; adolescence (12-20); availability of services; behavior genetics; behavior intervention; behavioral intervention; black American; children; chronic disease/disorder; chronic disorder; disease control; disease/disorder; disorder control; drug/agent; eighth grade; enroll; follow-up; health care availability; health care service access; health care service availability; health disparities; health disparity; health services availability; healthcare access availability; healthcare service access; healthcare service availability; high school; improved; individual responsibility; interest; intervention development; interventional strategy; juvenile; juvenile human; long-term study; medical schools; medication adherence; medication compliance; patient oriented research; patient oriented study; pediatric; post-doc; post-doctoral; professor; programs; prospective; public health medicine (field); public health relevance; randomized controlled study; recruit; skills; social role; statistics; study design; teenage; tenth grade; therapy development; treatment development; youngster
Project start date: 2009-06-15
Project end date: 2014-05-31
Budget start date: 1-JUN-2010
Budget end date: 31-MAY-2011
PFA/PA: PA-08-151
5K24HD058794-02 (2010): $111398
INTERVENTION FOR DEPRESSED LATINA MOTHERS OF CHILDREN WITH ASTHMA
Elizabeth L Mcquaid, Associate Professor Of Psychiatry (resea
Rhode Island Hospital, Providence, Ri 02903-4923
Grant 5R21HL095102-02 from National Heart, Lung, And Blood Institute
Abstract: Pediatric asthma, the most common childhood chronic illness, remains a significant public health problem. Research indicates marked health care disparities in asthma, with Latino children at particular risk for poor health outcomes. Maternal depressive symptoms are also high among poor women who have children with asthma, and may compromise effective asthma management. The first AIM of this R21 application is to develop a manualized treatment to integrate asthma education with CBT strategies to reduce depressive symptoms among Latina mothers of children with persistent asthma. Such an intervention has the potential to improve asthma outcomes through increasing maternal knowledge and self-efficacy to manage asthma. During Year 1, Expert Consultants and an investigator team with expertise in asthma education, culturally tailored treatment, and CBT for Latinos will provide input into the development of the integrated intervention (MAADRE, for its acronym in Spanish). Focus groups will be conducted with our target population in Rhode Island and Puerto Rico to refine intervention content. Qualitative data analyses will be used to prioritize intervention targets and to identify contextual differences between Island and Mainland groups. The second AIM of this application is to conduct a small two-site pilot of the MAADRE intervention in Rhode Island and Puerto Rico. During Year 2, we will test the intervention with depressed mothers of children with asthma (32 in Puerto Rico and 32 in Rhode Island.) Mothers will be randomly assigned to receive either the MAADRE intervention or asthma education + child health (control). We expect that target children of participants in the MAADRE intervention will have improved asthma outcomes (asthma symptom days, lung function as measured by FEV1 and FEV1/FVC, asthma-related quality of life, and asthma control) relative to the control condition. We also anticipate that participants in the MAADRE intervention will have greater reduction in depressive symptoms and improved self-efficacy to manage asthma relative to the control condition. Findings from the proposed application will be used to design a larger RCT to evaluate the effects of the MAADRE intervention on asthma outcomes, and to compare cost-effectiveness of the intervention approaches. Asthma is a common chronic illness in which minority children are disproportionately affected. A novel intervention that integrates asthma education with treatment for maternal depressive symptoms has great potential to improve outcomes for Latino children with asthma and their mothers
Keywords: 0-11 years old; Affect; Analysis, Data; Asthma; Asthma in Children; Behavior; Blood Coagulation Factor I; Blood Coagulation Factor One; Blood Factor One; Bronchial Asthma; Care, Health; Child; Child Youth; Child health care; Childhood; Childhood Asthma; Children (0-21); Chronic Disease; Chronic Illness; Coagulation Factor I; Coagulation Factor One; Communities; Community Health; Complex; Data; Data Analyses; Depressed mood; Depression; Development; Disease Management; Disorder Management; Education; Educational aspects; Effectiveness of Interventions; Emotional Depression; Endogenous depression; Epidemiology; Ethnic and Racial Minorities; FEV1; FEV1%VC; Factor I; Factor One; Family; Fibrinogen; Focus Groups; Forced Expiratory Volume 1 Test; Forced Expiratory Volume in 1 Second; HOSP; Health; Health Care Providers; Health Personnel; Health, Child; Healthcare; Healthcare Providers; Healthcare worker; Hospitalization; Human, Child; Intervention; Intervention Strategies; Investigators; Island; Knowledge; Latina; Latino; Link; Major Depressive Disorder; Measures; Mediating; Mental Depression; Minority; Minority Groups; Morbidity; Morbidity - disease rate; Mortality; Mortality Vital Statistics; Mothers; Outcome; PFT/FEV1; Participant; Pediatric asthma; Prevention; Prevention strategy; Preventive strategy; Public Health; Puerto Rico; Pulmonary Function Test/Forced Expiratory Volume 1; QOL; Quality of life; Randomized; Randomized Controlled Trials; Relative; Relative (related person); Research; Research Personnel; Researchers; Respiratory physiology; Rhode Island; Risk; Self Efficacy; Site; Smoking Status; Social support; Symptoms; Symptoms of depression; Target Populations; Testing; Time; Treatment Efficacy; Woman; acronyms; base; children; chronic disease/disorder; chronic disorder; clinical depression; communication behavior; coping; cost; cost effectiveness; depressed; depressed mother; depressive; depressive symptoms; design; designing; effect of intervention; health care personnel; health care worker; health provider; healthcare personnel; improved; interventional strategy; lung function; major depression; maternal cigarette smoking; maternal depression; maternal smoking; medical personnel; medication adherence; medication compliance; novel; pediatric; primary care setting; public health medicine (field); public health relevance; randomisation; randomization; randomized controlled study; randomly assigned; respiratory function; sadness; skills; social support network; therapeutic efficacy; therapeutically effective; treatment effect; treatment provider; youngster
Relevance: Asthma is a common chronic illness in which minority children are disproportionately affected. A novel intervention that integrates asthma education with treatment for maternal depressive symptoms has great potential to improve outcomes for Latino children with asthma and their mothers
Project start date: 2009-08-01
Project end date: 2011-05-31
Budget start date: 1-JUN-2010
Budget end date: 31-MAY-2011
PFA/PA: PA-06-181
5R21HL095102-02 (2010): $235257
1R21HL095102-01A1 (2009): $208855
COMMUNITY PARTNERSHIP TO REDUCE ASTHMA DISPARITIES
Elizabeth L Mcquaid, Associate Professor Of Psychiatry (resea
Rhode Island Hospital, Providence, Ri 02903-4923
Grant 5R01NR008524-04 from National Institute Of Nursing Research
Abstract: Pediatric asthma is increasingly common among minority children, and results in considerable healthcare disparity. This application seeks to establish a Community Partnership between Rhode Island Hospital and the Providence Community Health Centers to conduct a randomized, controlled trial to increase use of controller medications for asthma among Latino and African-American children. A Community Advisory Board of parents and key informants will provide ongoing input regarding treatment implementation. Families with children who have persistent asthma symptoms will be enrolled. Three groups will be recruited (N=240 total) African-American families, Latino families who prefer health care in Spanish, and Latino families who prefer health care in English. All families will be enrolled in a brief baseline period. Children who are prescribed oral or inhaled controller medications will have medication use monitored electronically. Research staff will also collect data regarding baseline medication use from pharmacy records and insurance claims. Asthma knowledge, medication beliefs, medication adherence, and asthma morbidity will be assessed at baseline, end of treatment, and at 3-month intervals until 1 year post-treatment. After completing a baseline, all families will attend a group-based asthma education class in their own Community Health Center (one of five CHC´s). Families will the be randomized to one of two nurse delivered interventions, either 1) a Standard Care (SC) condition, which emphasizes use of symptom monitoring, peak flow meter, trigger control measures, and a written action plan, or 2) a Medication Adherence (MA) condition, which assesses use of alternative medications, addresses concerns regarding use of controller medications, and uses problem-solving techniques to address barriers to medication use. Follow-up is conducted by researcher assistants at 3-, 6-, 9-, and 12-month time points post-intervention. It is expected that both interventions will increase asthma knowledge, but the MA intervention will yield greater controller medication use and decreased morbidity. It is further expected that differences in medication adherence post-treatment will be mediated by medication beliefs. Lastly, it is anticipated that within the Latino groups, Latinos with low English proficiency will demonstrate the greatest changes from baseline on medication adherence and morbidity. A Sustainability Advisory board will provide guidance regarding project implementation in the community beyond the life of the grant
Keywords: 0-11 years old; Active Follow-up; Address; Adherence; Adherence (attribute); African; African American; Afro American; Afroamerican; Anti-Inflammatories; Anti-Inflammatory Agents; Antiinflammatories; Antiinflammatory Agents; Aspiration, Respiratory; Asthma; Asthma in Children; Belief; Black Populations; Black or African American; Breathing; Bronchial Asthma; Care, Health; Caring; Child; Child Youth; Childhood Asthma; Children (0-21); Class; Clinical; Communication; Communities; Community Health Centers; Condition; Data; Dose; Drugs; Economics; Education; Education for Intervention; Educational Intervention; Educational aspects; Electronics; Enrollment; Ethnic Origin; Ethnic and Racial Minorities; Ethnicity; Ethnicity aspects; Family; Foundations; Grant; HOSP; Health behavior change; Healthcare; Healthy People 2010; History; Hospitals; Hospitals, Pediatric; Human, Child; Inhalation; Inhaling; Inspiration, Respiratory; Instruction Intervention; Insurance; Intervention; Intervention Strategies; Investigators; Knowledge; Language; Latino; Life; Measurement; Measures; Mediating; Medical; Medication; Methods and Techniques; Methods, Other; Minority; Minority Groups; Monitor; Morbidity; Morbidity - disease rate; Mortality; Mortality Vital Statistics; Nurses; Oral; Outcome; Parents; Pediatric Hospitals; Pediatric asthma; Personnel, Nursing; Pharmaceutic Preparations; Pharmaceutical Preparations; Pharmacies; Pharmacy facility; Prevalence; Problem Solving; Programs (PT); Programs [Publication Type]; Public Health; Randomized; Randomized Controlled Trials; Recording of previous events; Records; Recruitment Activity; Relative; Relative (related person); Research; Research Personnel; Research Resources; Researchers; Resources; Rhode Island; Satellite Centers; Standards; Standards of Weights and Measures; Symptoms; Techniques; Time; Training Intervention; Writing; base; black American; children; cost; disease control; disorder control; drug/agent; enroll; ethnic minority; ethnic minority population; follow-up; improved; innovate; innovation; innovative; inspiration; instructional intervention; interventional strategy; medication adherence; medication compliance; meter; new approaches; novel approaches; novel strategies; novel strategy; nursing intervention; preference; programs; public health medicine (field); randomisation; randomization; randomized controlled study; randomly assigned; recruit; skills; treatment effect; trend; youngster
Project start date: 2005-04-01
Project end date: 2011-03-31
Budget start date: 1-APR-2008
Budget end date: 31-MAR-2011
PFA/PA: PA-02-124
5R01NR008524-04 (2008): $0
5R01NR008524-03 (2007): $373030
5R01NR008524-02 (2006): $368431
1R01NR008524-01A2 (2005): $413341
TESTING INTERVENTIONS IN PEDIATRIC ASTHMA
Elizabeth L Mcquaid, Assistant Professor; Staff Psychologist
Rhode Island Hospital (providence, Ri)
providence, Ri 029034923
Grant 1R03HD039734-01 from Eunice Kennedy Shriver National Institute Of Child Health & Human Development IRG: CHHD
Abstract: Adapted from applicant´s description) This project seeks preliminary funding to compare two interventions to increase adherence and reduce morbidity for children with persistent asthma. Recent studies demonstrate that children with asthma typically take less than half of their prescribed doses of preventive medications. Targeting this problem specifically has the potential to improve symptoms, decrease morbidity, and decrease health care utilization in pediatric asthma. Focus groups will first be conducted to provide feedback regarding preliminary intervention materials. Then, 110 families with a child with persistent asthma (between 8-14) will be recruited into a month´s baseline, including electronic adherence assessment, and evaluation of asthma know1edge, self-efficacy, and morbidity. At the end of baseline, families whose children exhibit less than 70% adherence (expected n equals 60) will be randomized to one of two treatment conditions, either Behavioral Feedback (BF) or Asthma Education (AE). Each treatment consists of three individualized one-hour sessions over a month´s time. The BF condition includes feedback regarding medication use, problem-solving regarding adherence barriers, and behavioral contracting. The AE condition provides education regarding asthma biology and medications, environmental control, and symptom assessment and management. Adherence and asthma morbidity will be assessed during the intervention month, and one month post-treatment. It is expected that 1) Participants in the EF condition will demonstrate greater increases in adherence than participants in the AE condition and 2) Participants in the BF condition will have decreased functional morbidity due to asthma relative to participants receiving AE. Preliminary analyses will determine relevant covariates; key analyses will determine intervention effects within and across groups. Exploratory analyses will investigate mediators of behavior change. Results will be used to design a larger, randomized controlled trial comparing behavioral feedback to asthma education
Keywords: asthma, behavior therapy, education evaluation /planning, health education, human therapy evaluation, pediatrics, therapy compliance age difference, human morbidity, patient care management adolescence (12-18), audiotape, behavioral /social science research tag, human subject, interview, middle childhood (6-11), patient oriented research
Project start date: 2001-05-15
Project end date: 2003-04-30
1R03HD039734-01 (2001): $77000
DEVELOPMENTAL ASPECTS OF ADHERENCE IN PEDIATRIC ASTHMA
Elizabeth L Mcquaid, Assistant Professor; Staff Psychologist
Rhode Island Hospital (providence, Ri)
providence, Ri 029034923
Grant 5R03HD037023-02 from Eunice Kennedy Shriver National Institute Of Child Health & Human Development IRG: CAPR
Abstract: Adapted from applicant´s ) The present small grant application proposes an investigation of developmental aspects of adherence to pediatric asthma regimens, in order to identify psychological factors pertinent to asthma adherence and ultimately allow the design of developmentally appropriate interventions for improved adherence. Research in childhood chronic illness has indicated that adherence often decreases with age, although few studies have investigated the process that may account for this phenomenon. The present study proposes to assess developmental differences in medication adherence by assessing the interactive effects of the child´s developmental concepts of illness and degree of responsibility for asthma management in predicting adherence to asthma regimens, and to evaluate the role of asthma self-efficacy as a mediator in the prediction of asthma adherence from developmental concepts of illness and degree of responsibility for asthma management. One hundred children and adolescents with asthma, aged 10-18, will be interviewed to assess their developmental concepts of illness. Each child participant and a parent will complete questionnaires regarding asthma self-efficacy, prescribed medication regimen, and child responsibility for asthma tasks. Children will participate in a 2-month adherence assessment in which an MDI chronolog device is attached to their regular MDI inhaler(s). It is expected that 1) developmental concepts of illness will interact with the child´s degree of responsibility for asthma care to predict adherence to inhaled medications, and 2) the relationship between developmental illness concepts, asthma responsibility, and adherence to inhaled medications will ge mediated by asthma self-efficacy. Techniques of Multiple Regression will be used to examine relations between variables. It is expected that the proposed study will further the establishment of appropriate developmental guidelines for asthma care, and begin to identify critical periods in child development for increased education and intervention in pediatric asthma
Keywords: adolescence (12-18), asthma, child (0-11), child psychology, cognition, self care, therapy compliance chronic disease /disorder, concept, inhalation drug administration, pediatric pharmacology behavioral /social science research tag, clinical research, human subject, interview, questionnaire
Project start date: 1998-07-01
Project end date: 2001-06-30
5R03HD037023-02 (1999): $68839