251
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Molloy GJ, O'Carroll RE. Medication adherence across the lifespan: Theory, methods, interventions and six grand challenges. Psychol Health 2017; 32:1169-1175. [PMID: 28992794 DOI: 10.1080/08870446.2017.1316850] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- G J Molloy
- a School of Psychology , National University of Ireland Galway , Galway , Ireland.,b Whitaker Institute for Innovation and Societal Change , National University of Ireland Galway , Galway , Ireland
| | - R E O'Carroll
- c Psychology, School of Natural Sciences , University of Stirling , Stirling, FK9 4LA, Scotland , UK
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252
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Fedele DA, McConville A, Graham Thomas J, McQuaid EL, Janicke DM, Turner EM, Moon J, Abu-Hasan M. Applying Interactive Mobile health to Asthma Care in Teens (AIM2ACT): Development and design of a randomized controlled trial. Contemp Clin Trials 2017; 64:230-237. [PMID: 28986245 DOI: 10.1016/j.cct.2017.09.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 09/20/2017] [Accepted: 09/27/2017] [Indexed: 01/01/2023]
Abstract
Early adolescents have difficulties performing asthma self-management behaviors, placing them at-risk for poor asthma control and reduced quality of life. This paper describes the development and plans for testing an interactive mobile health (mHealth) tool for early adolescents, ages 12-15years, and their caregivers to help improve asthma management. Applying Interactive Mobile health to Asthma Care in Teens (AIM2ACT) is informed by the Pediatric Self-management model, which posits that helpful caregiver support is facilitated by elucidating disease management behaviors and allocating treatment responsibility in the family system, and subsequently engaging in collaborative caregiver-adolescent asthma management. The AIM2ACT intervention was developed through iterative feedback from an advisory board composed of adolescent-caregiver dyads. A pilot randomized controlled trial of AIM2ACT will be conducted with 50 early adolescents with poorly controlled asthma and a caregiver. Adolescent-caregiver dyads will be randomized to receive the AIM2ACT smartphone application (AIM2ACT app) or a self-guided asthma control condition for a 4-month period. Feasibility and acceptability data will be collected throughout the trial. Efficacy outcomes, including family asthma management, lung function, adolescent asthma control, asthma-related quality of life, and self-efficacy for asthma management, will be collected at baseline, post-treatment, and 4-month follow-up. Results from the current study will inform the utility of mHealth to foster the development of asthma self-management skills among early adolescents.
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Affiliation(s)
- David A Fedele
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States.
| | - Andrew McConville
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
| | - J Graham Thomas
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Elizabeth L McQuaid
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - David M Janicke
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
| | - Elise M Turner
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
| | - Jon Moon
- MEI Research, Ltd, Edina, MN, United States
| | - Mutasim Abu-Hasan
- Pediatric Pulmonary Division, University of Florida, Gainesville, FL, United States
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253
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Wu YP, Mays D, Kohlmann W, Tercyak KP. Pediatric Predispositional Genetic Risk Communication: Potential Utility for Prevention and Control of Melanoma Risk as an Exemplar. J Genet Couns 2017; 26:887-893. [PMID: 28547663 PMCID: PMC5702278 DOI: 10.1007/s10897-017-0105-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 04/25/2017] [Indexed: 12/20/2022]
Abstract
Predispositional genetic testing among minor children is intensely debated due to the potential benefits and harms of providing this type of genetic information to children and their families. Existing guidelines on pediatric genetic testing state that predispositional testing could be appropriate for minors if preventive services exist that mitigate children's risk for or severity of the health condition in question. We use the example of hereditary melanoma to illustrate the rationale for and potential application of genetic risk communication for an adult-onset cancer to a pediatric population where childhood behaviors may reduce risk of disease later in life. We draw from the adult melanoma genetic risk communication and pediatric health behavior change literatures to suggest ways in which genetic test reporting and complementary education could be delivered to children who carry a hereditary risk for melanoma and their families in order to foster children's engagement in melanoma preventive behaviors. Genetic discoveries will continue to yield new opportunities to provide predispositional genetic risk information to unaffected individuals, including children, and could be delivered within programs that provide personalized and translational approaches to cancer prevention.
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Affiliation(s)
- Yelena P Wu
- Division of Public Health, Department of Family & Preventive Medicine, University of Utah, 375 Chipeta Way, Suite A, Salt Lake City, UT, 84108, USA.
- Huntsman Cancer Institute, Salt Lake City, UT, USA.
| | - Darren Mays
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, D.C, USA
| | | | - Kenneth P Tercyak
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, D.C, USA
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254
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Kelly CS, Berg CA, Ramsey MA, Baker AC, Donaldson DL, Swinyard MT, Lindsay R, Murray M, Wiebe DJ. Relationships and the development of transition readiness skills into early emerging adulthood for individuals with type 1 diabetes. CHILDRENS HEALTH CARE 2017; 47:308-325. [PMID: 30906104 PMCID: PMC6426132 DOI: 10.1080/02739615.2017.1354294] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The study examined how 'transition readiness' skills develop from relationship processes with parents, friends, and healthcare providers. During their senior year of high school and one year later, participants (N = 217) with type 1 diabetes completed measures of transition readiness skills (Self-Management; Self-Advocacy), adherence, HbA1c, and relationships with providers (patient-centered communication), parents (monitoring/knowledge), and friends (knowledge/helpfulness) surrounding diabetes. Self-Management skills increased across time. Higher friend knowledge/helpfulness during emerging adulthood was associated with increased Self-Management skills. Adherence improved when relationships with providers and friends matched transition readiness skills, indicating that these relationships may facilitate transition skills in early emerging adulthood.
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Affiliation(s)
- Caitlin S. Kelly
- Department of Psychology, University of Utah, Salt Lake City, UT
| | - Cynthia A. Berg
- Department of Psychology, University of Utah, Salt Lake City, UT
| | - Meagan A. Ramsey
- Department of Psychology, University of Utah, Salt Lake City, UT
| | - Ashley C. Baker
- Psychological Sciences and Health Sciences Research Institute, University of California, Merced, Merced, CA
| | - David L. Donaldson
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT
| | | | - Rob Lindsay
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT
| | - Mary Murray
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT
| | - Deborah J. Wiebe
- Psychological Sciences and Health Sciences Research Institute, University of California, Merced, Merced, CA
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255
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Taş D, Çopur EÖ, Ünlü H, Tüzün Z, Özcebe LH. Quality of Life and Self-Efficacy of Adolescents with Chronic Health Conditions. DICLE MEDICAL JOURNAL 2017. [DOI: 10.5798/dicletip.339004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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256
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Coburn SS, Eakin MN, Roter D, Pruette C, Brady T, Mendley S, Tuchman S, Fivush B, Riekert KA. Patient-provider communication in nephrology care for adolescents and young adults. PATIENT EDUCATION AND COUNSELING 2017; 100:1680-1687. [PMID: 28433407 PMCID: PMC6476325 DOI: 10.1016/j.pec.2017.03.026] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 03/17/2017] [Accepted: 03/22/2017] [Indexed: 05/19/2023]
Abstract
OBJECTIVE To compare the relative quantity of talk between providers, caregivers, and adolescents and young adults (AYAs) with chronic kidney disease (CKD) and how communication differs by age. METHODS During nephrology clinic visits, conversations between AYAs with CKD (N=99, ages 11-20, median=15), their caregivers, and providers (N=19) were audiotaped and coded using the Roter Interaction Analysis System. Linear mixed models tested AYA age differences in talk frequency by AYAs, caregivers, and providers. Post-hoc analyses tested differences in talk using AYA age groups. RESULTS During clinic visits, providers spoke the most (63.7%), and caregivers spoke more (22.6%) than AYAs (13.7%). Overall talk differed by AYA age in AYAs (p<0.001) and caregivers (p<0.05), but not providers. Higher AYA age was associated with more AYA talk (biomedical information-giving, partnering, rapport-oriented) and less caregiver biomedical information-giving (ps<0.001-0.05). In post-hoc analyses, young adults talked more than adolescents; caregiver talk decreased in the middle-adolescent group. CONCLUSIONS Increases in AYA talk occur primarily in young adulthood, whereas caregiver talk decreases in middle adolescence. This may indicate an appropriate developmental shift but raises concerns about conversational gaps during middle-adolescence. PRACTICE IMPLICATIONS During transition-oriented treatment planning, providers should engage both AYAs and caregivers to avoid potential gaps in communication.
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Affiliation(s)
- S S Coburn
- The Johns Hopkins School of Medicine, Baltimore, MD, USA.
| | - M N Eakin
- The Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - D Roter
- The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - C Pruette
- The Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - T Brady
- The Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - S Mendley
- The University of Maryland School of Medicine, Baltimore, MD, USA
| | - S Tuchman
- Children's National Health System, Washington, D.C., USA
| | - B Fivush
- The Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - K A Riekert
- The Johns Hopkins School of Medicine, Baltimore, MD, USA
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257
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Morrison CF, Pai ALH, Martsolf D. Facilitators and Barriers to Self-Management for Adolescents and Young Adults Following a Hematopoietic Stem Cell Transplant [Formula: see text]. J Pediatr Oncol Nurs 2017; 35:36-42. [PMID: 28786302 DOI: 10.1177/1043454217723864] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Adolescents and young adults who experience hematopoietic stem cell transplant are at risk for self-management difficulties based on development, psychological comorbidities, and the complexity of the care regimen. Recommendations for practice change were designed to address facilitators and barriers to self-management for adolescents and young adults following hematopoietic stem cell transplant. As part of a grounded theory research study, 30 participants (17 adolescents and young adults and 13 of their caregivers) were individually interviewed and asked about facilitators and barriers to managing care and advice for health care providers. Participant responses were coded into categories, which were named with terms used by the participants. The number of participants who provided data per category was recorded. Self-management is generally characterized only in the ability to follow a prescribed care regimen. Participants indicated mental and emotional experiences as a result of treatment were indistinguishable from self-management activities. Facilitators included having a positive attitude, social support, organization, motivation, and information. Barriers included physical and psychological symptoms, isolation, difficulties with the medication regimen, single parenting, and having a bad attitude. Advice for health care providers included communicating effectively, treating patients holistically, and providing social support.
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Affiliation(s)
- Caroline F Morrison
- 1 Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,2 University of Cincinnati, College of Nursing, Cincinnati, OH, USA
| | - Ahna L H Pai
- 1 Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,3 University of Cincinnati, College of Medicine, Department of Pediatrics, Cincinnati, OH, USA
| | - Donna Martsolf
- 2 University of Cincinnati, College of Nursing, Cincinnati, OH, USA
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258
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Anderson BJ, Laffel LM, Domenger C, Danne T, Phillip M, Mazza C, Hanas R, Waldron S, Beck RW, Calvi-Gries F, Mathieu C. Factors Associated With Diabetes-Specific Health-Related Quality of Life in Youth With Type 1 Diabetes: The Global TEENs Study. Diabetes Care 2017; 40:1002-1009. [PMID: 28546221 PMCID: PMC5864137 DOI: 10.2337/dc16-1990] [Citation(s) in RCA: 108] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 04/21/2017] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Our objective was to characterize diabetes-specific health-related quality of life (D-HRQOL) in a global sample of youth and young adults with type 1 diabetes (T1D) and to identify the main factors associated with quality of life. RESEARCH DESIGN AND METHODS The TEENs study was an international, cross-sectional study of youth, 8-25 years of age, with T1D. Participants (N = 5,887) were seen in clinical sites in 20 countries across 5 continents enrolled for 3 predetermined age groups: 8-12, 13-18, and 19-25 years of age. To assess D-HRQOL, participants completed the PedsQL Diabetes Module 3.0 and were interviewed about family-related factors. Specifics about treatment regimen and self-management behaviors were collected from medical records. RESULTS Across all age groups, females reported significantly lower D-HRQOL than did males. The 19-25-year age group reported the lowest D-HRQOL. Multivariate linear regression analyses revealed that D-HRQOL was significantly related to HbA1c; the lower the HbA1c, the better the D-HRQOL. Three diabetes-management behaviors were significantly related to better D-HRQOL: advanced methods used to measure food intake; more frequent daily blood glucose monitoring; and more days per week that youth had ≥30 min of physical activity. CONCLUSIONS In all three age groups, the lower the HbA1c, the better the D-HRQOL, underscoring the strong association between better D-HRQOL and optimal glycemic control in a global sample of youth and young adults. Three diabetes-management behaviors were also related to optimal glycemic control, which represent potentially modifiable factors for clinical interventions to improve D-HRQOL as well as glycemic control.
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Affiliation(s)
| | | | | | - Thomas Danne
- Auf der Bult Kinder- und Jugendkrankenhaus, Hannover, Germany
| | - Moshe Phillip
- Institute for Endocrinology and Diabetes, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
| | - Carmen Mazza
- Hospital de Pediatria J.P. Garrahan, Buenos Aires, Argentina
| | - Ragnar Hanas
- Sahlgrenska Academy, Gothenburg, Sweden.,NU Hospital Group, Uddevalla, Sweden
| | - Sheridan Waldron
- National Children & Young People's Diabetes Network, London, U.K
| | - Roy W Beck
- Jaeb Center for Health Research, Tampa, FL
| | | | - Chantal Mathieu
- Clinical and Experimental Endocrinology, UZ Gasthuisberg, University of Leuven, Leuven, Belgium
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259
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260
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Corathers SD, Mara CA, Chundi PK, Kichler JC. Psychosocial Patient-Reported Outcomes in Pediatric and Adolescent Diabetes: a Review and Case Example. Curr Diab Rep 2017; 17:45. [PMID: 28508255 DOI: 10.1007/s11892-017-0872-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
PURPOSE OF REVIEW The purpose of this review is to define psychosocial patient-reported outcomes (PROs) relevant to pediatric and adolescent diabetes populations. Potential domains for PROs include a spectrum of emotional, behavioral, social, physical, overall health, and/or care management areas. A literature review of potential PRO measures, selection criteria, and implementation strategies including a case example will be presented. RECENT FINDINGS Among the pediatric, adolescent, and emerging adult populations, research indicates a relative higher risk for distress, depression, anxiety, and eating disorders as compared to peers without diabetes. Use of PRO measures can expand providers' focus beyond glycemic control, or simply hemoglobin A1c, to better appreciate the impact of diabetes on the whole child/adolescent, and provide services that address patients' individually identified needs, which are most salient to them. Successful selection and implementation of psychosocial PRO measures should be designed to include pathways for real-time provider interaction with the patient and respective PRO data to guide clinical care.
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Affiliation(s)
- Sarah D Corathers
- Division of Endocrinology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 7012, Cincinnati, OH, 45229, USA.
- James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
| | - Constance A Mara
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Pavan K Chundi
- James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Jessica C Kichler
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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261
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Babcock L, Kurowski BG, Zhang N, Dexheimer JW, Dyas J, Wade SL. Adolescents with Mild Traumatic Brain Injury Get SMART: An Analysis of a Novel Web-Based Intervention. Telemed J E Health 2017; 23:600-607. [PMID: 28112591 PMCID: PMC5549803 DOI: 10.1089/tmj.2016.0215] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Revised: 10/16/2016] [Accepted: 10/17/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND There have been few trials of interventions to facilitate recovery following mild traumatic brain injury (mTBI) in adolescence. To address this gap, we developed and piloted a novel Web-based intervention, entitled Self-Management Activity Restriction and Relaxation Training (SMART), and examined its impact on symptom burden, functional disability, and executive functioning during the month following mTBI in adolescents. MATERIALS AND METHODS Open-label, single arm study. Adolescents with recent mTBI and a parent were recruited from the emergency department and provided access upon discharge to SMART-a Web-based program designed to facilitate recovery via self-management and education about symptoms and sequelae associated with mTBI. Symptom burden, functional disability, and executive functioning were rated by both the adolescent and the parent initially and at assessments at 1-, 2- and 4-weeks postinjury. Mixed models analyses were used to examine trajectories on these outcomes. RESULTS Of the 21 adolescent/parent dyads enrolled, 13 engaged in the program and reported significant improvement in symptoms over the 4-week program (adolescent, p = 0.0005; parent, p = 0.004). Adolescents spent a median of 35.5 min (range 1.1-107.6) using the program. Parent ratings of the adolescent's functional disability and executive functioning significantly improved over the 4-week period from baseline (p = 0.009 and p = 0.03, respectively), whereas adolescents themselves did not report significant changes in either outcome. All participants improved and there were no adverse outcomes. CONCLUSION The SMART program, a novel Web-based intervention, may serve as a self-management tool for adolescents and their parents to assist with the recovery following a recent mTBI.
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Affiliation(s)
- Lynn Babcock
- Division of Emergency Medicine, Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Brad G. Kurowski
- Division of Physical Medicine and Rehabilitation, Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Nanhua Zhang
- Division of Biostatistics and Epidemiology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Judith W. Dexheimer
- Division of Emergency Medicine, Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, Ohio
- Department of Biomedical Informatics, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Jenna Dyas
- Division of Emergency Medicine, Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Shari L. Wade
- Division of Physical Medicine and Rehabilitation, Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, Ohio
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262
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Delay discounting and parental monitoring in adolescents with poorly controlled type 1 diabetes. J Behav Med 2017; 40:864-874. [PMID: 28500504 DOI: 10.1007/s10865-017-9856-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Accepted: 04/29/2017] [Indexed: 01/04/2023]
Abstract
In a sample of adolescents with poorly controlled type 1 diabetes, this study examined if delay discounting, the extent to which individuals prefer immediate over delayed rewards, was associated with severity of non-adherence and poor glycemic control, and if parental monitoring of diabetes management moderated those associations. Sixty-one adolescents (M age = 15.08 years, SD 1.43) with poorly controlled type 1 diabetes completed a delayed discounting task and an HbA1c blood test. Adherence was assessed via self-monitoring of blood glucose (SMBG) data from adolescents' glucometers. Parents completed a parental monitoring questionnaire. Greater delay discounting was associated with higher HbA1c, but not SMBG. Direct parent observation of diabetes tasks, but not indirect parental monitoring, moderated the link between greater delay discounting and higher HbA1c, with higher direct parent observation buffering the link between greater discounting and poorer glycemic control. Delay discounting may be a target for future interventions to improve HbA1c in youth with type 1 diabetes.
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263
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Barry SA, Teplitsky L, Wagner DV, Shah A, Rogers BT, Harris MA. Partnering with Insurers in Caring for the Most Vulnerable Youth with Diabetes: NICH as an Integrator. Curr Diab Rep 2017; 17:26. [PMID: 28321766 DOI: 10.1007/s11892-017-0849-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
PURPOSE OF REVIEW In this review, we outline barriers to appropriately caring for high-risk youth with diabetes and discuss efforts in partnering with insurers through Alternative Payment Models to achieve the Triple Aim (improved health, improved care, and reduced costs) for this population. RECENT FINDINGS Current approaches in caring for youth with diabetes who evidence a high degree of social complexity are woefully ineffective. These youth are vulnerable to repeat diabetic ketoacidosis episodes, poor glycemic control, and excessive utilization of healthcare resources. To effectively pursue the Triple Aim, an "integrator" (i.e., an entity that accepts responsibility for all components of the Triple Aim for a specified population) must be identified; however, this does not fit into current fee-for-service models. Integrators for youth with diabetes are limited, but early examples of integrator efforts are promising. We present one successful "integrator," Novel Interventions in Children's Healthcare (NICH), and detail this program's efforts in partnering with insurers to serve high-risk youth with diabetes.
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Affiliation(s)
- Samantha A Barry
- University of Massachusetts Medical Center, Diabetes Center of Excellence, UMass Medical School, 368 Plantation St., Worcester, MA, 01605, USA
| | - Lena Teplitsky
- Oregon Health & Science University OHSU, 707 SW Gaines Street, Portland, OR, 97239, USA
| | - David V Wagner
- Oregon Health & Science University OHSU, 707 SW Gaines Street, Portland, OR, 97239, USA
| | - Amit Shah
- CareOregon, 315 SW 5th Ave, Portland, OR, 97204, USA
| | - Brian T Rogers
- Oregon Health & Science University OHSU, 707 SW Gaines Street, Portland, OR, 97239, USA
| | - Michael A Harris
- Oregon Health & Science University OHSU, 707 SW Gaines Street, Portland, OR, 97239, USA.
- Harold Schnitzer Diabetes Health Center, Portland, OR, 97239, USA.
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264
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Lansing AH, Turner SL, Osborn PG, Winnick JB, Taheri K, Murray M, Butner J, Wiebe DJ, Berg CA. Academic achievement and metabolic control in adolescents with type 1 diabetes. CHILDRENS HEALTH CARE 2017. [DOI: 10.1080/02739615.2016.1275641] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
| | - Sara L. Turner
- Department of Psychology, University of Utah, Salt Lake City, UT
| | - Peter G. Osborn
- Department of Psychology, University of Utah, Salt Lake City, UT
| | - Joel B. Winnick
- Clearinghouse for Military Family Readiness, Pennsylvania State University, University Park, PA
| | - Kiana Taheri
- Department of Psychology, University of Utah, Salt Lake City, UT
| | - Mary Murray
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT
| | - Jonathan Butner
- Department of Psychology, University of Utah, Salt Lake City, UT
| | - Deborah J. Wiebe
- Department of Psychological Sciences, University of California, Merced, Merced, CA
| | - Cynthia A. Berg
- Department of Psychology, University of Utah, Salt Lake City, UT
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265
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Lenti MV, Selinger CP. Medication non-adherence in adult patients affected by inflammatory bowel disease: a critical review and update of the determining factors, consequences and possible interventions. Expert Rev Gastroenterol Hepatol 2017; 11:215-226. [PMID: 28099821 DOI: 10.1080/17474124.2017.1284587] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Achieving adherence to medications can be a serious challenge for patients affected by inflammatory bowel disease (IBD). Medical treatment is fundamental for inducing and maintaining remission, preventing flares and reducing the risk of colorectal cancer. Non-adherence may affect patients' quality of life resulting in unfavourable treatment outcomes, more hospitalizations and higher healthcare-related costs. Recognising and improving adherence is therefore a primary aim for the treatment of IBD. Areas covered: We critically discuss the current knowledge on medication non-adherence in adult patients affected by IBD, also mentioning a few issues concerning the paediatric and adolescent populations. In particular, we reviewed the literature focusing on the definition and detection of non-adherence, on its extent and on the possible non-modifiable and modifiable factors involved (patient-centred, therapy-related, disease-related and physician-related). Furthermore, we analysed the interventional studies performed so far. The literature review was conducted through PubMed addressing medication non-adherence in IBD, using the keywords 'adherence' and related terms and 'IBD, ulcerative colitis or Crohn's disease'. Expert commentary: Adherence to therapy for IBD is a complex yet fundamental issue that cannot be solved by addressing a single aspect only. Future studies should focus on patient-tailored and multidimensional interventions.
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Affiliation(s)
- Marco Vincenzo Lenti
- a First Department of Internal Medicine , San Matteo Hospital Foundation; University of Pavia , Pavia , Italy.,b Department of Gastroenterology , Leeds Teaching Hospitals NHS Trust, University of Leeds , Leeds , UK
| | - Christian P Selinger
- b Department of Gastroenterology , Leeds Teaching Hospitals NHS Trust, University of Leeds , Leeds , UK
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266
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Wagner JL, Modi AC, Johnson EK, Shegog R, Escoffery C, Bamps Y, Austin JK, Schultz RJ, MapelLentz S, Smith G. Self-management interventions in pediatric epilepsy: What is the level of evidence? Epilepsia 2017; 58:743-754. [PMID: 28233908 DOI: 10.1111/epi.13711] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2017] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To respond to recommendations put forth by the Institute of Medicine to improve self-management resources for youth with epilepsy by conducting a systematic review of the self-management literature in pediatric epilepsy. METHODS Inclusion criteria: youth birth to 18 years with a seizure disorder or an epilepsy diagnosis and/or their caregivers, published 1985-2014 in English, and conducted in countries with a very high human development index. Abstract and keywords had to explicitly refer to "self-care" (pre-1996) and/or self-management (post-1996). The review was conducted in seven phases: (1) identification of bibliographical search criteria and databases; (2) abstract assessment; (3) full article review; (4) organization of final citations into instrument development, intervention, factors associated with self-management categories; (5) American Academy of Neurology level of evidence (LOE) assessment for intervention studies; (6) CONsolidated Standards of Reporting Trials (CONSORT) evaluation of LOE level III articles utilizing a control group; and (7) categorization of intervention outcomes across four self-management domains. RESULTS Of the 87 articles that met eligibility criteria, 24 were interventions and received LOE scores of level III or IV. Most studies (n = 20, 80%) were scored at level III; however, only eight had a control group and adhered to CONSORT guidelines. They largely neglected information on intervention components (e.g., implementation, treatment fidelity), randomization, participant flow, missing data, and effect size or confidence intervals. The 24 intervention studies reported significant impact in four domains: individual (n = 13), family (n = 6), health care system (n = 3), and community (n = 2). SIGNIFICANCE There are no level I or II studies. No study met full CONSORT guidelines. Outcomes were well described; however, the nature of self-management interventions (e.g., multiple foci, skills targeted) and the observed heterogeneity in outcomes complicates comparisons across studies. Randomized controlled trials (RCTs) that include large sample sizes, impact of the intervention, treatment fidelity, and power analyses are necessary to further this evidence base.
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Affiliation(s)
- Janelle L Wagner
- Department of Pediatrics, College of Nursing, Medical University of South Carolina, Charleston, South Carolina, U.S.A
| | - Avani C Modi
- Center for Treatment Adherence and Self-Management, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, U.S.A
| | - Erica K Johnson
- Harborview Medical Center, University of Washington, Seattle, Washington, U.S.A
| | - Ross Shegog
- Prevention Research Center & School of Public Health, University of Texas, Houston, Texas, U.S.A
| | - Cam Escoffery
- Department of Behavioral Sciences & Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia, U.S.A
| | - Yvan Bamps
- Department of Behavioral Sciences & Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia, U.S.A
| | - Joan K Austin
- School of Nursing, Indiana University-Purdue University Indianapolis, Bloomington, Indiana, U.S.A
| | - Rebecca J Schultz
- Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, U.S.A
| | - Sarah MapelLentz
- Department of Pediatrics & Adolescent Health, University of Minnesota, Minneapolis, Minnesota, U.S.A
| | - Gigi Smith
- Department of Pediatrics, College of Nursing, Medical University of South Carolina, Charleston, South Carolina, U.S.A
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267
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Hilliard ME, Powell PW, Anderson BJ. Evidence-based behavioral interventions to promote diabetes management in children, adolescents, and families. ACTA ACUST UNITED AC 2017; 71:590-601. [PMID: 27690487 DOI: 10.1037/a0040359] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
As members of multidisciplinary diabetes care teams, psychologists are well-suited to support self-management among youth with Type 1 diabetes (T1D) and Type 2 diabetes (T2D) and their families. Psychological and behavioral interventions can promote adherence to the complex and demanding diabetes care regimen, with the goals of promoting high quality of life, achieving optimal glycemic control, and ultimately preventing disease-related complications. This article reviews well-researched contemporary behavioral interventions to promote optimal diabetes family- and self-management and health outcomes in youth with T1D, in the context of key behavioral theories. The article summarizes the evidence base for established diabetes skills training programs, family interventions, and multisystemic interventions, and introduces emerging evidence for technology and mobile health interventions and health care delivery system interventions. Next steps in behavioral T1D intervention research include tailoring interventions to meet individuals' and families' unique needs and strengths, and systematically evaluating cost-effectiveness to advocate for dissemination of well-developed interventions. Although in its infancy, this article reviews observational and intervention research for youth with T2D and their families and discusses lessons for future research with this population. Interventions for youth with T2D will need to incorporate family members, consider cultural and family issues related to health behaviors, and take into account competing priorities for resources. As psychologists and behavioral scientists, we must advocate for the integration of behavioral health into routine pediatric diabetes care in order to effectively promote meaningful change in the behavioral and medical well-being of youth and families living with T1D and T2D. (PsycINFO Database Record
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268
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Ersig AL, Starkweather AR. An Integrative Review of Biological Variants and Chronic Stress in Emerging Adults With Chronic Conditions. J Nurs Scholarsh 2017; 49:185-193. [PMID: 28166375 DOI: 10.1111/jnu.12281] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2016] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of this integrative review was to evaluate and synthesize studies that incorporated biological measures and examined their associations with chronic stress and anxiety in adolescents and emerging adults with chronic health conditions. DESIGN An integrative literature review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement to identify studies published between 2005 and 2015. METHODS Using key terms, three databases (PubMed/Medline, PsycInfo and the Cumulative Index to Nursing and Allied Health Literature) were searched by a research librarian. Additional publications with relevance to the topic were identified from citing and cited literature. The full text of 61 publications was reviewed. The final group of articles analyzed for this review included 36 peer-reviewed publications and meeting abstracts. FINDINGS Studies varied considerably in characteristics, theoretical frameworks, phenotypes of interest, and study measures. Few studies evaluated genomic variants; those that did often examined small samples and a limited number of biological factors. CONCLUSIONS Studies of chronic stress and anxiety in adolescents and emerging adults with chronic health conditions are currently limited in scope and impact. A more comprehensive approach will facilitate translation into practice to improve short- and long-term health outcomes. CLINICAL RELEVANCE Precision and genomic healthcare initiatives support the relevance of this work for nurses in all areas of clinical practice. Genomic testing is expanding to include individuals in all age groups, with and without diagnosed conditions. As psychological and behavioral phenotypes may influence self-management outcomes of adolescents and emerging adults with chronic health conditions, further research in this area is warranted.
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Affiliation(s)
- Anne L Ersig
- Gamma, Nurse Researcher, Center for Pediatric Nursing Research & Evidence Based Practice, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
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269
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Wasserman R, Anderson BJ, Schwartz DD. Illness-Specific Risk-Taking in Adolescence: A Missing Piece of the Nonadherence Puzzle for Youth With Type 1 Diabetes? Diabetes Spectr 2017; 30:3-10. [PMID: 28270709 PMCID: PMC5309908 DOI: 10.2337/ds15-0060] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Risky behavior is often at its lifetime peak in adolescence. Chronic illness creates additional opportunities for risk because nonadherence behaviors can jeopardize adolescents' health. Adolescents with type 1 diabetes could engage in risky behavior around insulin administration that would put them in danger of severe health consequences. It is possible that some nonadherence behaviors observed in adolescents with type 1 diabetes may result from youth taking risks with their medical treatment. Illness-specific risk-taking behaviors are not captured in most assessments of adherence, which primarily focus on frequency of adherence behaviors. This article reviews current models of general risk-taking and their implications for diabetes management. The authors argue that illness-specific risk-taking may be an important, understudied aspect of illness management that can inform future studies and treatment of nonadherence in adolescents with type 1 diabetes.
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270
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Sage A, Roberts C, Geryk L, Sleath B, Tate D, Carpenter D. A Self-Regulation Theory-Based Asthma Management Mobile App for Adolescents: A Usability Assessment. JMIR Hum Factors 2017; 4:e5. [PMID: 28148471 PMCID: PMC5311420 DOI: 10.2196/humanfactors.7133] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Revised: 01/12/2017] [Accepted: 01/15/2017] [Indexed: 11/13/2022] Open
Abstract
Background Self-regulation theory suggests people learn to influence their own behavior through self-monitoring, goal-setting, feedback, self-reward, and self-instruction, all of which smartphones are now capable of facilitating. Several mobile apps exist to manage asthma; however, little evidence exists about whether these apps employ user-centered design processes that adhere to government usability guidelines for mobile apps. Objective Building upon a previous study that documented adolescent preferences for an asthma self-management app, we employed a user-centered approach to assess the usability of a high-fidelity wireframe for an asthma self-management app intended for use by adolescents with persistent asthma. Methods Individual interviews were conducted with adolescents (ages 11-18 years) with persistent asthma who owned a smartphone (N=8). Adolescents were asked to evaluate a PDF app wireframe consisting of 76 screen shots displaying app features, including log in and home screen, profile setup, settings and info, self-management features, and graphical displays for charting asthma control and medication. Preferences, comments, and suggestions for each set of screen shots were assessed using the audio-recorded interviews. Two coders reached consensus on adolescent evaluations of the following aspects of app features: (1) usability, (2) behavioral intentions to use, (3) confusing aspects, and (4) suggestions for improvement. Results The app wireframe was generally well received, and several suggestions for improvement were recorded. Suggestions included increased customization of charts and notifications, reminders, and alerts. Participants preferred longitudinal data about asthma control and medication use to be displayed using line graphs. All participants reported that they would find an asthma management app like the one depicted in the wireframe useful for managing their asthma. Conclusions Early stage usability tests guided by government usability guidelines (usability.gov) revealed areas for improvement for an asthma self-management app for adolescents. Addressing these areas will be critical to developing an engaging and effective asthma self-management app that is capable of improving adolescent asthma outcomes.
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Affiliation(s)
- Adam Sage
- Division of Pharmaceutical Outcomes and Policy, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Courtney Roberts
- Division of Pharmaceutical Outcomes and Policy, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Lorie Geryk
- Division of Pharmaceutical Outcomes and Policy, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Betsy Sleath
- Division of Pharmaceutical Outcomes and Policy, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Deborah Tate
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.,Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Delesha Carpenter
- Division of Pharmaceutical Outcomes and Policy, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
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271
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Tanenbaum ML, Hanes SJ, Miller KM, Naranjo D, Bensen R, Hood KK. Diabetes Device Use in Adults With Type 1 Diabetes: Barriers to Uptake and Potential Intervention Targets. Diabetes Care 2017; 40:181-187. [PMID: 27899489 PMCID: PMC5864141 DOI: 10.2337/dc16-1536] [Citation(s) in RCA: 176] [Impact Index Per Article: 25.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 11/04/2016] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Diabetes devices (insulin pumps, continuous glucose monitors [CGMs]) are associated with benefits for glycemic control, yet uptake of these devices continues to be low. Some barriers to device uptake may be modifiable through psychosocial intervention, but little is known about which barriers and which patients to target. RESEARCH DESIGN AND METHODS We surveyed 1,503 adult T1D Exchange participants (mean age 35.3 [SD 14.8] years, mean diagnosis duration 20.4 [SD 12.5] years) to investigate barriers to device uptake, understand profiles of device users versus nonusers, and explore differences by age and sex. Scales used were the Diabetes Distress Scale, Technology Use Attitudes (General and Diabetes-Specific), and Barriers to Device Use and Reasons for Discontinuing Devices. RESULTS Most commonly endorsed modifiable barriers were related to the hassle of wearing devices (47%) and disliking devices on one's body (35%). CGM users (37%) were older than nonusers (mean 38.3 vs. 33.5 years), had diabetes for longer (22.9 vs. 18.8 years), had more positive technology attitudes (22.6-26.0 vs. 21.4-24.8), and reported fewer barriers to using diabetes technology than nonusers (3.3 vs. 4.3). The youngest age-group (18-25 years) had the lowest CGM (26% vs. 40-48%) and insulin pump (64% vs. 69-77%) uptake, highest diabetes distress (2.2 vs. 1.8-2.1), and highest HbA1c levels (8.3% [67 mmol/mol] vs. 7.2-7.4% [55-57 mmol/mol]). CONCLUSIONS Efforts to increase device use need to target physical barriers to wearing devices. Because young adults had the lowest device uptake rates, highest distress, and highest HbA1c compared with older age-groups, they should be the focus of future interventions to increase device use.
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Affiliation(s)
- Molly L Tanenbaum
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA
| | - Sarah J Hanes
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA
| | | | - Diana Naranjo
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA
| | - Rachel Bensen
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA
| | - Korey K Hood
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA
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272
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Chawana TD, Katzenstein D, Nathoo K, Ngara B, Nhachi CFB. Evaluating an enhanced adherence intervention among HIV positive adolescents failing atazanavir/ritonavir-based second line antiretroviral treatment at a public health clinic. ACTA ACUST UNITED AC 2017; 9:17-30. [PMID: 31649827 PMCID: PMC6812532 DOI: 10.5897/jahr2016.0406] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Sustaining virological suppression among HIV-infected adolescents is challenging. We evaluated a home-based adherence intervention and characterized self-reported adherence, virological response and drug resistance among adolescents failing atazanavir/ritonavir (ATV/r)-based 2nd line treatment.
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Affiliation(s)
| | - David Katzenstein
- Department of Medicine, Division of Infectious Diseases, Stanford University, California
| | - Kusum Nathoo
- Department of Paediatrics, University of Zimbabwe, Harare 00263, Zimbabwe
| | - Bernard Ngara
- Department of Community Medicine, University of Zimbabwe, Harare 00263, Zimbabwe
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273
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Morrison CF, Martsolf DM, Wehrkamp N, Tehan R, Pai ALH. Medication Adherence in Hematopoietic Stem Cell Transplantation: A Review of the Literature. Biol Blood Marrow Transplant 2017; 23:562-568. [PMID: 28087458 DOI: 10.1016/j.bbmt.2017.01.008] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Accepted: 01/03/2017] [Indexed: 12/13/2022]
Abstract
Adherence to oral medications has been repeatedly shown to fall below the recommended 80% to 95% in pediatric and adult cancer populations. The purpose of this review is to report the state of the science about oral medication adherence during the acute phase of hematopoietic stem cell transplantation across the lifespan. An exhaustive search of the literature yielded 5 records for inclusion in the review. Two studies examined adherence in pediatrics, 2 in adults, and 1 included both pediatric and adult patients. Three studies were descriptive and 2 were interventional in design. The rate of adherence to oral medications ranged from 33% to 94.7%. Adherence decreased over time in all studies except in 1 pharmacist-led intervention study. Different methods were used to measure adherence, but most relied on self-report. Further research is needed in medication adherence in hematopoietic stem cell transplantation to better understand facilitators, barriers, and relationships to health outcomes.
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Affiliation(s)
- Caroline F Morrison
- Center for the Promotion of Adherence and Self-Management, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
| | | | - Nicole Wehrkamp
- College of Nursing, University of Cincinnati, Cincinnati, Ohio
| | - Rebecca Tehan
- College of Nursing, University of Cincinnati, Cincinnati, Ohio
| | - Ahna L H Pai
- Center for the Promotion of Adherence and Self-Management, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Patient and Family Wellness Center, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati School of Medicine, Cincinnati, Ohio
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274
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Crosby LE, Ware RE, Goldstein A, Walton A, Joffe NE, Vogel C, Britto MT. Development and evaluation of iManage: A self-management app co-designed by adolescents with sickle cell disease. Pediatr Blood Cancer 2017; 64:139-145. [PMID: 27574031 PMCID: PMC7354646 DOI: 10.1002/pbc.26177] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 07/10/2016] [Accepted: 07/11/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Adolescents and young adults (AYAs) with sickle cell disease (SCD) are a vulnerable population with high risk of morbidity that could be decreased with effective self-management. Previous research suggests that mobile applications (apps) may facilitate AYA engagement in health-promoting behaviors. The objectives of this study were: (i) describe Internet access and use in AYA with SCD; (ii) identify barriers for self-management in this population; (iii) collaborate with AYA to co-design a mobile app that would minimize barriers; and (iv) evaluate the feasibility and acceptability of the app. PROCEDURE In phase 1, 46 AYAs with SCD 16-24 years of age completed a survey of Internet access and use. During phase 2, 19 AYAs with SCD (average age 20 ± 2.5 years) and eight healthcare providers participated in interviews to identify barriers and co-design sessions to develop the app. In phase 3, five AYAs with SCD completed app feasibility and usability testing. RESULTS AYAs with SCD had daily Internet access (69%) using their computers (84%) or mobile phones (70%). Participants went online for health information (71%) and preferred Web sites with interactive/social features (83%). Barriers to self-management included failing to believe that their health would suffer, lack of tailored self-management support, lack of a mechanism to visualize self-management progress, and limited opportunities for peer interaction around self-management. The prototype app (iManage) was rated as highly feasible and beneficial. CONCLUSIONS A mobile app prototype co-designed by AYAs with SCD may be a useful tool for engaging them in self-management strategies designed to improve health.
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Affiliation(s)
- Lori E. Crosby
- Division of Behavioral Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH,James M. Anderson Center for Health Systems Excellence, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - Russell E. Ware
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH,Division of Hematology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | | | - Ashley Walton
- Division of Behavioral Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH,Department of Psychology, University of Cincinnati, Cincinnati, OH
| | - Naomi E. Joffe
- Division of Behavioral Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Craig Vogel
- College of Design, Architecture, Art, and Planning, University of Cincinnati, Cincinnati, OH
| | - Maria T. Britto
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH,Division of Adolescent Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH,James M. Anderson Center for Health Systems Excellence, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
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275
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Heath G, Farre A, Shaw K. Parenting a child with chronic illness as they transition into adulthood: A systematic review and thematic synthesis of parents' experiences. PATIENT EDUCATION AND COUNSELING 2017; 100:76-92. [PMID: 27693084 DOI: 10.1016/j.pec.2016.08.011] [Citation(s) in RCA: 111] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2016] [Revised: 07/28/2016] [Accepted: 08/08/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To understand how parents view and experience their role as their child with a long-term physical health condition transitions to adulthood and adult healthcare services. METHODS Five databases were systematically searched for qualitative articles examining parents' views and experiences of their child's healthcare transition. Papers were quality assessed and thematically synthesised. RESULTS Thirty-two papers from six countries, spanning a 17-year period were included. Long-term conditions were diverse. Findings indicated that parents view their child's progression toward self-care as an incremental process which they seek to facilitate through up-skilling them in self-management practices. Parental perceptions of their child's readiness, wellness, competence and long-term condition impacted on the child' progression to healthcare autonomy. A lack of transitional healthcare and differences between paediatric and adult services served as barriers to effective transition. Parents were required to adjust their role, responsibilities and behaviour to support their child's growing independence. CONCLUSION Parents can be key facilitators of their child's healthcare transition, supporting them to become experts in their own condition and care. To do so, they require clarification on their role and support from service providers. PRACTICE IMPLICATIONS Interventions are needed which address the transitional care needs of parents as well as young people.
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Affiliation(s)
- Gemma Heath
- Department of Psychology, School of Life and Health Sciences, Aston University, Birmingham, B4 7ET, UK.
| | - Albert Farre
- Research and Development, Birmingham Children's Hospital, Birmingham, UK; Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Karen Shaw
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
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276
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Abstract
The objective is to examine the prevalence and health-care costs associated with asthma, epilepsy, hypertension, food allergies, and diabetes in children aged 0-18 years. Prevalence was calculated using 2005-2012 Medical Expenditure Panel Survey (MEPS) data, a population-based, nationally representative sample. Using MEPS, two-part models estimated the cost of each condition for all children while controlling for sociodemographic categories. Prevalence rates varied by race and ethnicity across conditions. Females had higher prevalence of all chronic conditions, except epilepsy. An additional US$1,377.60-US$9,059.49 annually were spent on medical expenses for children aged 0-18 years, with asthma, diabetes, or epilepsy compared to children without these conditions. This is the first study to examine the costs and prevalence of chronic health conditions in children and adolescents using a single data set. Understanding the odds of having a condition by sociodemographic categories highlights disparities that can potentially inform school nurses on the best allocation of resources to serve students.
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Affiliation(s)
- Gabrielle F Miller
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Edward Coffield
- Department of Health Professions, Hofstra University, Hempstead, NY, USA
| | - Zanie Leroy
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
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277
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Wiebe DJ, Helgeson V, Berg CA. The social context of managing diabetes across the life span. AMERICAN PSYCHOLOGIST 2016; 71:526-538. [PMID: 27690482 PMCID: PMC5094275 DOI: 10.1037/a0040355] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Diabetes self-management is crucial to maintaining quality of life and preventing long-term complications, and it occurs daily in the context of close interpersonal relationships. This article examines how social relationships are central to meeting the complex demands of managing Type I and Type 2 diabetes across the life span. The social context of diabetes management includes multiple resources, including family (parents, spouses), peers, romantic partners, and health care providers. We discuss how these social resources change across the life span, focusing on childhood and adolescence, emerging adulthood, and adulthood and aging. We review how diabetes both affects and is affected by key social relationships at each developmental period. Despite high variability in how the social context is conceptualized and measured across studies, findings converge on the characteristics of social relationships that facilitate or undermine diabetes management across the life span. These characteristics are consistent with both Interpersonal Theory and Self-Determination Theory, 2 organizing frameworks that we utilize to explore social behaviors that are related to diabetes management. Involvement and support from one's social partners, particularly family members, is consistently associated with good diabetes outcomes when characterized by warmth, collaboration, and acceptance. Underinvolvement and interactions characterized by conflict and criticism are consistently associated with poor diabetes outcomes. Intrusive involvement that contains elements of social control may undermine diabetes management, particularly when it impinges on self-efficacy. Implications for future research directions and for interventions that promote the effective use of the social context to improve diabetes self-management are discussed. (PsycINFO Database Record
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278
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Plevinsky JM, Greenley RN, Fishman LN. Self-management in patients with inflammatory bowel disease: strategies, outcomes, and integration into clinical care. Clin Exp Gastroenterol 2016; 9:259-67. [PMID: 27601930 PMCID: PMC5003515 DOI: 10.2147/ceg.s106302] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Self-management, including medication adherence, is associated with improved health and outcomes for patients with inflammatory bowel disease. The concept of self-management is complex, but can be divided into those aspects that involve the individual patient, those that involve the provider–patient relationship, and those that encompass the social environment. At the individual level, enhancing problem-solving skills and self-efficacy have both been shown to improve self-management tasks, particularly adherence to treatment. However, it is critical to consider these domains from a lifespan perspective because these processes by which self-management can be improved are distinct for children, adolescents, young adults, and adults. A particular emphasis is placed on strategies to improve self-management of older adolescents and young adults as they transition from pediatric to adult providers. The review concludes with recommendations for providers, including rationale and techniques for assessing and promoting patient self-efficacy, encouraging the development of problem-solving skills, improving the patient–provider relationship, and enhancing social support. Providers are encouraged to utilize elements of problem-solving skills training, engage in collaborative relationships with their patients, and offer their patients recommendations for how to increase the quality of their social support networks as ways of increasing overall self-management.
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Affiliation(s)
- Jill M Plevinsky
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, IL
| | - Rachel N Greenley
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, IL
| | - Laurie N Fishman
- Department of Gastroenterology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
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279
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Bal MI, Sattoe JNT, Roelofs PDDM, Bal R, van Staa A, Miedema HS. Exploring effectiveness and effective components of self-management interventions for young people with chronic physical conditions: A systematic review. PATIENT EDUCATION AND COUNSELING 2016; 99:1293-1309. [PMID: 26954345 DOI: 10.1016/j.pec.2016.02.012] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Revised: 01/25/2016] [Accepted: 02/23/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To systematically explore the effectiveness and effective components of self-management interventions. METHODS Study selection criteria were: Original articles in English published between 2003 and 2015; focusing on youth with chronic conditions; describing self-management interventions; with clear outcome measures; using RCT design. The random effects analysis was applied in which standardized mean differences per study were calculated. RESULTS 42 RCTs were included. Interventions focused on medical management, provided individually in clinical settings or at home by mono-disciplinary teams showed a trend in improving adherence. Interventions delivered individually at home by mono-disciplinary teams showed a trend in improving dealing with a chronic condition. CONCLUSIONS AND PRACTICAL IMPLICATIONS Adherence could be improved through interventions focused on medical management, provided individually in a clinical or home setting by a mono-disciplinary team. Interventions focused on dealing with a chronic condition might be provided individually, through telemedicine programs facilitating peer-support. These intervention elements seemed effective irrespective of diagnosis, and may therefore act as good starting points for further research into and for improvement of self-management support for youth with chronic conditions in pediatric care. Results underlined the need to systematically develop and evaluate self-management interventions, since this may provide more evidence for effectiveness and effective intervention components.
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Affiliation(s)
- Marjolijn I Bal
- Rotterdam University of Applied Sciences, Research Centre Innovations in Care, Rotterdam, The Netherlands; Erasmus University Medical Center, Department of Rehabilitation Medicine, Rotterdam, The Netherlands.
| | - Jane N T Sattoe
- Rotterdam University of Applied Sciences, Research Centre Innovations in Care, Rotterdam, The Netherlands; Erasmus University Rotterdam, Institute of Health Policy & Management, Rotterdam, The Netherlands.
| | - Pepijn D D M Roelofs
- Rotterdam University of Applied Sciences, Research Centre Innovations in Care, Rotterdam, The Netherlands.
| | - Roland Bal
- Erasmus University Rotterdam, Institute of Health Policy & Management, Rotterdam, The Netherlands.
| | - AnneLoes van Staa
- Rotterdam University of Applied Sciences, Research Centre Innovations in Care, Rotterdam, The Netherlands; Erasmus University Rotterdam, Institute of Health Policy & Management, Rotterdam, The Netherlands.
| | - Harald S Miedema
- Rotterdam University of Applied Sciences, Research Centre Innovations in Care, Rotterdam, The Netherlands.
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280
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Nguyen T, Henderson D, Stewart D, Hlyva O, Punthakee Z, Gorter JW. You never transition alone! Exploring the experiences of youth with chronic health conditions, parents and healthcare providers on self-management. Child Care Health Dev 2016; 42:464-72. [PMID: 27103590 PMCID: PMC5021141 DOI: 10.1111/cch.12334] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 01/21/2016] [Accepted: 02/04/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND Recent evidence suggests that fostering strategies to enable youth with chronic health conditions to work towards gradual self-management of their health is key in successful transition to adult healthcare. To date, there is limited research on self-management promotion for youth. The purpose of this study is to explore self-management from the perspectives of youth, parents and healthcare providers in transition to adult healthcare. METHODS Part of a larger longitudinal transition (TRACE-2009-2013) study, interpretive phenomenology was used to explore the meaning of the lived experiences and perceptions of youth, parents, and healthcare providers about transition to adult healthcare. Purposeful sampling was utilized to select youth with a range of chronic health conditions from the TRACE cohort (spanning 20 diagnoses including developmental disabilities and chronic conditions), their parents and healthcare providers. RESULTS The emerging three themes were: increasing independence of youth; parents as safety nets and healthcare providers as enablers and collaborators. The findings indicate that the experiences of transitioning youth, parents and service providers are interconnected and interdependent. CONCLUSIONS Results support a dynamic and developmentally appropriate approach when working with transitioning youth and parents in practice. As youth depend on parents and healthcare providers for support in taking charge of their own health, parents and healthcare providers must work together to enable youth for self-management. At a policy level, adequate funding, institutional support and accreditation incentives are recommended to allow for designated time for healthcare providers to foster self-management skills in transitioning youth and parents.
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Affiliation(s)
- T Nguyen
- School of Rehabilitation Science, McMaster University, Hamilton, Canada
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada
| | | | - D Stewart
- School of Rehabilitation Science, McMaster University, Hamilton, Canada
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada
| | - O Hlyva
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada
- Department of Pediatrics, McMaster University, Hamilton, Canada
| | - Z Punthakee
- Department of Pediatrics, McMaster University, Hamilton, Canada
- School of Medicine, McMaster University, Hamilton, Canada
| | - J W Gorter
- School of Rehabilitation Science, McMaster University, Hamilton, Canada
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada
- Department of Pediatrics, McMaster University, Hamilton, Canada
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281
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Distelberg BJ, Emerson ND, Gavaza P, Tapanes D, Brown WN, Shah H, Williams-Reade J, Montgomery S. A Cost-Benefit Analysis of a Family Systems Intervention for Managing Pediatric Chronic Illness. JOURNAL OF MARITAL AND FAMILY THERAPY 2016; 42:371-382. [PMID: 27282311 PMCID: PMC4938762 DOI: 10.1111/jmft.12166] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Despite recent increases of psychosocial programs for pediatric chronic illness, few studies have explored their economic benefits. This study investigated the costs-benefits of a family systems-based, psychosocial intervention for pediatric chronic illness (MEND: Mastering Each New Direction). A quasi-prospective study compared the 12-month pre-post direct and indirect costs of 20 families. The total cost for program was estimated to $5,320. Families incurred $15,249 less in direct and $15,627 less in indirect costs after MEND. On average, medical expenses reduced by 86% in direct and indirect costs, for a cost-benefit ratio of 0.17. Therefore, for every dollar spent on the program, families and their third payers saved approximately $5.74. Implications for healthcare policy and reimbursements are discussed.
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282
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Ramsey RR, Ryan JL, Fedele DA, Mullins LL, Chaney JM, Wagner JL. Child Attitude Toward Illness Scale (CATIS): A systematic review of the literature. Epilepsy Behav 2016; 59:64-72. [PMID: 27096812 DOI: 10.1016/j.yebeh.2016.03.026] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 03/16/2016] [Accepted: 03/17/2016] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The objective of this study was to systematically review the literature utilizing the Child Attitude Toward Illness Scale (CATIS) as a measure of illness attitudes within pediatric chronic illness, including epilepsy, and provide recommendations for its use. This review includes an examination of the psychometric properties of the CATIS and the relationship between the CATIS and psychological, academic, behavioral, and illness variables. METHOD Electronic searches were conducted using Medline and PsychINFO to identify twenty-two relevant publications. RESULTS The CATIS was identified as a reliable and valid self-report assessment tool across chronic illnesses, including pediatric epilepsy. Although originally developed for children ages 8-12, the CATIS has demonstrated reliability and validity in youth ages 8-22. The CATIS scores were reliably associated with cognitive appraisal variables and internalizing symptoms. Initial support exists for the relation between illness attitudes and externalizing behavior, academic functioning, and psychosocial care needs. Mixed findings were reported with regard to the relation between illness attitudes and demographic and disease variables, as well as both social and family functioning. CONCLUSION The CATIS is a psychometrically sound self-report instrument for measuring illness attitudes and demonstrates clinical utility for examining adjustment outcomes across chronic illnesses, particularly pediatric epilepsy.
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Affiliation(s)
- Rachelle R Ramsey
- Center for Adherence and Self-Management, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Jamie L Ryan
- Center for Adherence and Self-Management, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - David A Fedele
- Department of Clinical and Health Psychology, University of Florida, United States
| | - Larry L Mullins
- Department of Psychology, Oklahoma State University, Stillwater, OK, United States
| | - John M Chaney
- Department of Psychology, Oklahoma State University, Stillwater, OK, United States
| | - Janelle L Wagner
- Comprehensive Epilepsy Center, College of Nursing, Department of Pediatrics, Medical University of South Carolina, United States.
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283
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Nguyen E, Bugno L, Kandah C, Plevinsky J, Poulopoulos N, Wojtowicz A, Schneider KL, Greenley RN. Is There a Good App for That? Evaluating m-Health Apps for Strategies That Promote Pediatric Medication Adherence. Telemed J E Health 2016; 22:929-937. [PMID: 27070837 DOI: 10.1089/tmj.2015.0211] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Mobile health medication reminder apps may be a useful supplement to traditional adherence-promotion interventions for pediatric chronic illness populations because they can give real-time reminders and provide education and promote behavior modification (components known to enhance adherence in traditional interventions) in an engaging and developmentally acceptable way. Moreover, apps have the potential to be used by youth and parents, an important consideration given that shared involvement in condition management is associated with better adherence. INTRODUCTION This study evaluated the content and usability of existing medication reminder apps operating on the Apple platform. MATERIALS AND METHODS Two researchers coded 101 apps on 15 desirable reminder, educational, and behavioral modification features. Usability testing was conducted with the subset of apps (n = 8) that had the greatest number of content features using a validated measure. RESULTS Apps contained an average of 4.21 of 15 content features, with medication reminder features being more common than either educational or behavioral modification features. Apps most commonly included a medication name storage feature (95%), a time-based reminder feature (87%), and a medication dosage storage feature (68%). Of the eight apps that had the highest number of content features, Mango Health, myRX Planner, and MediSafe evidenced the highest usability ratings. No apps identified were specifically designed for pediatric use. DISCUSSION Most apps lacked content known to be useful in traditional pediatric adherence-promotion interventions. Greater attention to educational and behavioral modification features may enhance the usefulness of medication reminder apps for pediatric groups. CONCLUSION Collaborations between behavioral medicine providers and app developers may improve the quality of medication reminder apps for use in pediatric populations.
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Affiliation(s)
- Eve Nguyen
- Department of Psychology, Rosalind Franklin University of Medicine and Science , North Chicago, Illinois
| | - Lindsey Bugno
- Department of Psychology, Rosalind Franklin University of Medicine and Science , North Chicago, Illinois
| | - Cassandra Kandah
- Department of Psychology, Rosalind Franklin University of Medicine and Science , North Chicago, Illinois
| | - Jill Plevinsky
- Department of Psychology, Rosalind Franklin University of Medicine and Science , North Chicago, Illinois
| | - Natasha Poulopoulos
- Department of Psychology, Rosalind Franklin University of Medicine and Science , North Chicago, Illinois
| | - Andrea Wojtowicz
- Department of Psychology, Rosalind Franklin University of Medicine and Science , North Chicago, Illinois
| | - Kristin L Schneider
- Department of Psychology, Rosalind Franklin University of Medicine and Science , North Chicago, Illinois
| | - Rachel Neff Greenley
- Department of Psychology, Rosalind Franklin University of Medicine and Science , North Chicago, Illinois
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284
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Addressing Psychosocial Adversity Within the Patient-Centered Medical Home: Expert-Created Measurable Standards. J Prim Prev 2016; 36:213-25. [PMID: 25787893 DOI: 10.1007/s10935-015-0390-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The Patient-Centered Medical Home (PCMH) may be improved by embedding identification and response for patients' experiences with psychosocial adversity, but how this might optimally occur in practice has not been well-specified. We sought input from an expert panel to define feasible elements that could adapt the PCMH to adequately respond to patients' experiences with psychosocial adversity. From December 2012 through September 2013, we used a Delphi process to systematically obtain expert opinions and reach consensus. We invited 37 experts to participate in three successive and iterative rounds of questionnaires, with each round based on aggregated, de-identified data from the prior round. We first asked experts to generate elements to adapt the PCMH, using the National Committee for Quality Assurance (NCQA's) established six PCMH standards as the foundation. We then asked the experts to rate these elements on a 5-point Likert scale, and finally specify what they considered the most and least valuable elements. Eighteen of the 37 (49 %) invited experts responded to the first survey, and constituted our sample. Experts identified 35 elements that fell under the six NCQA standards. The top rated elements included using a screening tool to identify adversity; training providers to address psychosocial adversity; having a team member with mental health expertise; providing culturally-competent care; and having written patient information related to adversity and coping. This study derived key elements that may enhance the PCMH's ability to improve patient outcomes by purposefully identifying and responding to their psychosocial adversity.
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285
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Ho G, Ueda K, Houben RFA, Joa J, Giezen A, Cheng B, van Karnebeek CDM. Metabolic Diet App Suite for inborn errors of amino acid metabolism. Mol Genet Metab 2016; 117:322-7. [PMID: 26748688 DOI: 10.1016/j.ymgme.2015.12.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Revised: 12/21/2015] [Accepted: 12/21/2015] [Indexed: 12/31/2022]
Abstract
BACKGROUND An increasing number of rare inborn errors of metabolism (IEMs) are amenable to targeted metabolic nutrition therapy. Daily adherence is important to attain metabolic control and prevent organ damage. This is challenging however, given the lack of information of disorder specific nutrient content of foods, the limited availability and cost of specialty products as well as difficulties in reliable calculation and tracking of dietary intake and targets. OBJECTIVES To develop apps for all inborn errors of amino acid metabolism for which the mainstay of treatment is a medical diet, and obtain patient and family feedback throughout the process to incorporate this into subsequent versions. METHODS & RESULTS The Metabolic Diet App Suite was created with input from health care professionals as a free, user-friendly, online tool for both mobile devices and desktop computers (http://www.metabolicdietapp.org) for 15 different IEMs. General information is provided for each IEM with links to useful online resources. Nutrient information is based on the MetabolicPro™, a North American food database compiled by the Genetic Metabolic Dietitians International (GMDI) Technology committee. After user registration, a personalized dashboard and management plan including specific nutrient goals are created. Each Diet App has a user-friendly interface and the functions include: nutrient intake counts, adding your own foods and homemade recipes and, managing a daily food diary. Patient and family feedback was overall positive and specific suggestions were used to further improve the App Suite. DISCUSSION The Metabolic Diet App Suite aids individuals affected by IEMs to track and plan their meals. Future research should evaluate its impact on patient adherence, metabolic control, quality of life and health-related outcomes. The Suite will be updated and expanded to Apps for other categories of IEMs. Finally, this Suite is a support tool only, and does not replace medical/metabolic nutrition professional advice.
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Affiliation(s)
- Gloria Ho
- Division of Biochemical Diseases, BC Children's Hospital, University of British Columbia, Vancouver, Canada
| | - Keiko Ueda
- Division of Biochemical Diseases, BC Children's Hospital, University of British Columbia, Vancouver, Canada
| | | | | | - Alette Giezen
- Division of Biochemical Diseases, BC Children's Hospital, University of British Columbia, Vancouver, Canada
| | - Barbara Cheng
- Division of Biochemical Diseases, BC Children's Hospital, University of British Columbia, Vancouver, Canada
| | - Clara D M van Karnebeek
- Division of Biochemical Diseases, BC Children's Hospital, University of British Columbia, Vancouver, Canada; Department of Pediatrics, Centre for Molecular Medicine & Therapeutics, Child and Family Research Institute, University of British Columbia, Vancouver, Canada.
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286
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Michaelis R, Tang V, Wagner JL, Modi AC, LaFrance W, Goldstein LH, Lundgren T, Reuber M. Psychological treatments for people with epilepsy. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2016. [DOI: 10.1002/14651858.cd012081] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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287
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Tsimicalis A, Denis-Larocque G, Michalovic A, Lepage C, Williams K, Yao TR, Palomo T, Dahan-Oliel N, Le May S, Rauch F. The psychosocial experience of individuals living with osteogenesis imperfecta: a mixed-methods systematic review. Qual Life Res 2016; 25:1877-96. [PMID: 26894269 DOI: 10.1007/s11136-016-1247-0] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2016] [Indexed: 12/16/2022]
Abstract
PURPOSE Osteogenesis imperfecta (OI) is a genetic disorder (prevalence: 1:10,000), leading to bone fragility, frequent fractures, and varying degrees of physical limitations. Despite a substantial amount of research on the genetics, pathophysiology, and treatments related to OI, there remains a paucity of knowledge concerning the lived psychosocial experience of the OI population. This mixed-methods systematic review aimed to review, appraise, and synthesize the literature on the psychosocial experience of children and adults with OI with the goal of identifying implications for research, practice, and policy-making. METHODS Using a systematic methodology, quantitative, qualitative, and mixed-methods studies were accessed through database searching, screened, assessed for eligibility, and appraised. Data from the selected studies fulfilling the eligibility and quality criteria were extracted and synthesized using thematic analysis with an inductive approach. RESULTS A total of four qualitative and 20 quantitative studies, with various study designs and methodologies ranging in quality, were included in the review (n = 800; comprising 610 children and 175 adults with OI types I, III, IV, and V, ten parents and five healthcare professionals). Six themes were identified: intellectual feats, isolation and feeling different, fear of fractures, coping with challenges, adapting by learning new skills, and social relationships. CONCLUSION These findings highlighted key aspects of the experiences of children and adults with OI and will be essential for improving the quality and direction of research, tailoring clinical interventions addressing the psychosocial needs and quality of life of individuals with OI, and raising awareness among caregivers, healthcare professionals, administrators, and policy-makers associated with the OI population.
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Affiliation(s)
- Argerie Tsimicalis
- Ingram School of Nursing, Faculty of Medicine, McGill University, Wilson Hall, 3506 University St., Montreal, QC, H3A 2A7, Canada.
- Shriners Hospitals for Children-Canada, Montreal, QC, Canada.
| | - Gabrielle Denis-Larocque
- Ingram School of Nursing, Faculty of Medicine, McGill University, Wilson Hall, 3506 University St., Montreal, QC, H3A 2A7, Canada
| | - Alisha Michalovic
- Ingram School of Nursing, Faculty of Medicine, McGill University, Wilson Hall, 3506 University St., Montreal, QC, H3A 2A7, Canada
| | - Carolann Lepage
- Ingram School of Nursing, Faculty of Medicine, McGill University, Wilson Hall, 3506 University St., Montreal, QC, H3A 2A7, Canada
| | - Karl Williams
- Ingram School of Nursing, Faculty of Medicine, McGill University, Wilson Hall, 3506 University St., Montreal, QC, H3A 2A7, Canada
| | - Tian-Ran Yao
- Ingram School of Nursing, Faculty of Medicine, McGill University, Wilson Hall, 3506 University St., Montreal, QC, H3A 2A7, Canada
| | - Telma Palomo
- Shriners Hospitals for Children-Canada, Montreal, QC, Canada
- Bone and Mineral Unit, Division of Endocrinology, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Noemi Dahan-Oliel
- Shriners Hospitals for Children-Canada, Montreal, QC, Canada
- School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Sylvie Le May
- CHU Ste-Justine, Montreal, QC, Canada
- Faculty of Nursing, University of Montreal, Montreal, QC, Canada
| | - Frank Rauch
- Shriners Hospitals for Children-Canada, Montreal, QC, Canada
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288
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Barker DH, Quittner AL. Parental Depression and Pancreatic Enzymes Adherence in Children With Cystic Fibrosis. Pediatrics 2016; 137:e20152296. [PMID: 26738883 PMCID: PMC4732358 DOI: 10.1542/peds.2015-2296] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/28/2015] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Treatment adherence in cystic fibrosis (CF) is often poor, however, less is known about adherence to pancreatic enzymes, a critical component of the CF treatment regimen. Parent caregivers often report elevations in depression, and parental depression may adversely affect children's adherence. METHODS This prospective study evaluated adherence to pancreatic enzymes in 83 patients (1-13 years) . Adherence was measured across 3 months with electronic pill-caps . Weight was measured at baseline and a 3-month follow-up. Parental depressive symptoms were evaluated by using the Center for Epidemiologic Studies Depression Scale (CES-D). RESULTS Adherence to pancreatic enzymes was 49.4% ± 3.4%. Adherence was higher at school (94.4% ± 6.1%) than at home (42.3% ± 3.1%), and higher for toddlers (50.6% ± 5.2%) than for school-aged children (37.5% ± 3.7%). Parents reported high rates of depressive symptoms (30% in the clinical range, 18% with moderate symptoms). Children of parents with symptoms of depression versus those without were less adherent (34.8% ± 4.5% vs 48.5% ± 4.1%), and adherence to enzymes was significantly related to 3-month weight outcomes. Average gain in weight z scores across 3 months was 0.5 ± 0.2for children who were >50% adherent and -0.1 ± 6.1for children who were <33% adherent. Parental depression had a signifcant, indirect effect on weight via adherence (-0.005 ± 0.003 gain in weight z score per CES-D unit ). CONCLUSIONS High rates of parental depressive symptoms, coupled with its negative effects on adherence, suggest that measuring and treating parental depression may improve children's adherence to therapy.
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Affiliation(s)
- David H. Barker
- Department of Psychiatry, Rhode Island Hospital, Providence, Rhode Island;,Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, Rhode Island; and
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289
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Syed IA, Nathan PC, Barr R, Rosenberg-Yunger ZRS, D'Agostino NM, Klassen AF. Examining factors associated with self-management skills in teenage survivors of cancer. J Cancer Surviv 2016; 10:686-91. [PMID: 26802017 DOI: 10.1007/s11764-016-0514-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Accepted: 01/02/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND Monitoring long-term health of teenage cancer survivors is dependent on successful transition from pediatric to adult long-term follow-up (LTFU) care. This study identified factors associated with self-management skills (SMSs), an important correlate of successful transition. METHODS Data were collected from a cross-sectional survey conducted at three Canadian hospitals between July 2011 and January 2012. The sample included 184 childhood cancer survivors aged between 15 and 19 years. Independent factors included demographic- and illness-related factors. The outcome of interest was SMSs, measured using the SMSs scale, with higher scores indicating more SMSs. RESULTS More SMSs were associated positively with older age (β = 1.2, 95 % confidence interval (CI) = 0.1 to 2.4), being female (β = 4.6, 95 % CI = 1.9 to 7.4), and having a non-married parent (β = 5.2, 95 % CI = 0.04 to 10.4). There was a negative association between SMSs and having had a central nervous system tumor (CNS) compared to having leukemia (β = -7.9, 95 % CI = -13.5 to -2.2). CONCLUSIONS Younger, male, and CNS tumor survivors lack SMSs. Future research is needed to explore the extent and nature of associations between SMSs and parents' marital status. IMPLICATIONS FOR CANCER SURVIVORS Younger, male, and CNS tumor survivors should be targeted for interventions in order to ensure that adequate SMSs are attained before completion of transition.
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Affiliation(s)
- Iqra A Syed
- Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Paul C Nathan
- Department of Pediatrics and Institute of Health Policy, Management and Evaluation, The Hospital for Sick Children and the University of Toronto, Toronto, ON, Canada
| | - Ronald Barr
- Departments of Pediatrics, Pathology and Medicine, McMaster University, Hamilton, Canada
| | - Zahava R S Rosenberg-Yunger
- School of Health Services Management, Ryerson University, Toronto, Canada.,Ontario Pharmacists Association, Toronto, Canada
| | | | - Anne F Klassen
- Department of Pediatrics, McMaster University, 3A, 1280 Main Street W., Hamilton, ON, Canada, L8S 4K1.
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290
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Ferrand RA, Briggs D, Ferguson J, Penazzato M, Armstrong A, MacPherson P, Ross DA, Kranzer K. Viral suppression in adolescents on antiretroviral treatment: review of the literature and critical appraisal of methodological challenges. Trop Med Int Health 2016; 21:325-33. [PMID: 26681359 PMCID: PMC4776345 DOI: 10.1111/tmi.12656] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Objective Medication adherence is often suboptimal for adolescents with HIV, and establishing correct weight‐based antiretroviral therapy dosing is difficult, contributing to virological failure. This review aimed to determine the proportion of adolescents achieving virological suppression after initiating ART. Methods MEDLINE, EMBASE and Web of Science databases were searched. Studies published between January 2004 and September 2014 including ≥50 adolescents taking ART and reporting on the proportion of virological suppressed participants were included. Results From a total of 5316 potentially relevant citations, 20 studies were included. Only eight studies reported the proportion of adolescents that were virologically suppressed at a specified time point. The proportion of adolescents with virological suppression at 12 months ranged from 27 to 89%. Conclusion Adolescent achievement of HIV virological suppression was highly variable. Improved reporting of virological outcomes from a wider range of settings is required to support efforts to improve HIV care and treatment for adolescents.
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Affiliation(s)
| | - Datonye Briggs
- London School of Hygiene and Tropical Medicine, London, UK
| | | | | | | | - Peter MacPherson
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK.,Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - David A Ross
- London School of Hygiene and Tropical Medicine, London, UK
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291
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Wu YP, Aspinwall LG, Michaelis TC, Stump T, Kohlmann WG, Leachman SA. Discussion of photoprotection, screening, and risk behaviors with children and grandchildren after melanoma genetic testing. J Community Genet 2016; 7:21-31. [PMID: 26099287 PMCID: PMC4715817 DOI: 10.1007/s12687-015-0243-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 06/04/2015] [Indexed: 12/20/2022] Open
Abstract
The purpose of the current study was to examine changes in frequency of discussion about melanoma preventive behaviors among adults who received melanoma genetic test reporting and counseling and their children and grandchildren, correspondence of frequency of discussion with intentions, and content of discussions. Participants received CDKN2A/p16 testing and counseling (N = 24, 46 % p16-positive). Discussions about preventive behaviors were assessed before testing and 1 and 6 months post-testing. Intentions to discuss preventive behaviors and perceived preparedness to discuss risk were assessed post-testing. Open-ended questions assessed content of reported discussions. Discussion of preventive behaviors declined following test reporting, with more rapid decline reported by noncarriers. There was a large gap between the percentage of participants who intended to discuss preventive behaviors and who then reported discussions 1 and 6 months after counseling. Participants felt prepared to discuss melanoma risk but also suggested resources to facilitate discussions. Genetic test reporting and counseling alone did not sustain discussions about preventive behaviors for a hereditary cancer with children and grandchildren. The gap between intentions to have discussions and reported discussions has implications for augmentation of counseling to support at-risk families' discussions about preventive behaviors.
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Affiliation(s)
- Yelena P Wu
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah, 375 Chipeta Way, Suite A, Salt Lake City, UT, 84108, USA.
- Huntsman Cancer Institute, 2000 Circle of Hope Drive, Salt Lake City, UT, 84112, USA.
| | - Lisa G Aspinwall
- Department of Psychology, University of Utah, 380 South 1530 East, Salt Lake City, UT, 84112, USA
| | - Timothy C Michaelis
- School of Medicine, University of Utah, 30 North 1900 East, Salt Lake City, UT, 84132, USA
| | - Tammy Stump
- Department of Psychology, University of Utah, 380 South 1530 East, Salt Lake City, UT, 84112, USA
| | - Wendy G Kohlmann
- Huntsman Cancer Institute, 2000 Circle of Hope Drive, Salt Lake City, UT, 84112, USA
| | - Sancy A Leachman
- Department of Dermatology, Oregon Health and Science University, 3303 Southwest Bond Avenue, Portland, OR, 97239, USA
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292
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Johnson KB, Patterson BL, Ho YX, Chen Q, Nian H, Davison CL, Slagle J, Mulvaney SA. The feasibility of text reminders to improve medication adherence in adolescents with asthma. J Am Med Inform Assoc 2015; 23:449-55. [PMID: 26661717 DOI: 10.1093/jamia/ocv158] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Accepted: 09/20/2015] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVE Personal health applications have the potential to help patients with chronic disease by improving medication adherence, self-efficacy, and quality of life. The goal of this study was to assess the impact of MyMediHealth (MMH) - a website and a short messaging service (SMS)-based reminder system - on medication adherence and perceived self-efficacy in adolescents with asthma. METHODS We conducted a block-randomized controlled study in academic pediatric outpatient settings. There were 98 adolescents enrolled. Subjects who were randomized to use MMH were asked to create a medication schedule and receive SMS reminders at designated medication administration times for 3 weeks. Control subjects received action lists as a part of their usual care. Primary outcome measures included MMH usage patterns and self-reports of system usability, medication adherence, asthma control, self-efficacy, and quality of life. RESULTS Eighty-nine subjects completed the study, of whom 46 were randomized to the intervention arm. Compared to controls, we found improvements in self-reported medication adherence (P = .011), quality of life (P = .037), and self-efficacy (P = .016). Subjects reported high satisfaction with MMH; however, the level of system usage varied widely, with lower use among African American patients. CONCLUSIONS MMH was associated with improved medication adherence, perceived quality of life, and self-efficacy.Trial Registration This project was registered under http://clinicaltrials.gov/ identifier NCT01730235.
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Affiliation(s)
- Kevin B Johnson
- Department of Biomedical Informatics at Vanderbilt University School of Medicine, Nashville, TN, USA Department of Pediatrics at Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Barron L Patterson
- Department of Pediatrics at Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Yun-Xian Ho
- Department of Biomedical Informatics at Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Qingxia Chen
- Department of Biomedical Informatics at Vanderbilt University School of Medicine, Nashville, TN, USA Department of Biostatistics at Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Hui Nian
- Department of Biostatistics at Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Coda L Davison
- Department of Biomedical Informatics at Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Jason Slagle
- Department of Anesthesiology at Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Shelagh A Mulvaney
- Department of Biomedical Informatics at Vanderbilt University School of Medicine, Nashville, TN, USA School of Nursing at Vanderbilt University School of Medicine, Nashville, TN, USA
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293
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Pai ALH, McGrady ME. Assessing Medication Adherence as a Standard of Care in Pediatric Oncology. Pediatr Blood Cancer 2015; 62 Suppl 5:S818-28. [PMID: 26700926 DOI: 10.1002/pbc.25795] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 09/08/2015] [Accepted: 09/10/2015] [Indexed: 11/08/2022]
Abstract
Poor adherence to pediatric cancer treatment protocols may prevent children and adolescents from realizing the potential benefits of therapy. This paper presents the evidence for a standard of care for supporting medication adherence. Databases were reviewed for articles examining adherence and including children and/or adolescents with cancer. Fourteen articles (i.e., qualitative, quantitative, review, and randomized clinical trials) were evaluated for rigor. There is moderate-quality evidence to support a strong recommendation for adherence to be assessed routinely and monitored throughout the treatment. Integrating the proposed clinical procedures into standard clinical care may improve outcomes for children and adolescents with cancer.
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Affiliation(s)
- Ahna L H Pai
- Patient and Family Wellness Center, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.,Division of Behavioral Medicine and Clinical Psychology, Center for Adherence and Self-Management, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Meghan E McGrady
- Patient and Family Wellness Center, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.,Division of Behavioral Medicine and Clinical Psychology, Center for Adherence and Self-Management, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
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294
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Gandhi K, Vu BMK, Eshtehardi SS, Wasserman RM, Hilliard ME. Adherence in adolescents with Type 1 diabetes: strategies and considerations for assessment in research and practice. DIABETES MANAGEMENT (LONDON, ENGLAND) 2015; 5:485-498. [PMID: 27066110 PMCID: PMC4824320 DOI: 10.2217/dmt.15.41] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Suboptimal adherence remains a significant concern for adolescents with Type 1 diabetes, the treatment regimen for which is complex and includes numerous behaviors. Accurate assessment of adherence is critical for effective healthcare and to measure trial outcomes. Without a valid biomarker of adherence, assessment strategies must rely on measuring management behaviors. This paper provides an overview of approaches to measure adherence, with an emphasis on contemporary, validated measures that are appropriate for current diabetes care. Objective measures include electronic data from diabetes management devices. Subjective measures include self/parent-report questionnaires, structured interviews and diaries/logbooks. Practical strategies for selecting measurement approaches for clinical and research purposes are reviewed, and implications of adherence assessment for clinical care delivery and adherence-promotion are discussed.
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Affiliation(s)
- Kajal Gandhi
- Section of Pediatric Diabetes & Endocrinology, Department of Pediatrics, Baylor College of Medicine, 6701 Fannin Street, Suite 1020, Houston, TX 77030, USA
| | - Bach-Mai K Vu
- Section of Pediatric Diabetes & Endocrinology, Department of Pediatrics, Baylor College of Medicine, 6701 Fannin Street, Suite 1020, Houston, TX 77030, USA
| | - Sahar S Eshtehardi
- Section of Psychology, Department of Pediatrics, Baylor College of Medicine, 1102 Bates Avenue, Suite 940, Houston, TX 77030, USA
| | - Rachel M Wasserman
- Section of Psychology, Department of Pediatrics, Baylor College of Medicine, 1102 Bates Avenue, Suite 940, Houston, TX 77030, USA
| | - Marisa E Hilliard
- Section of Psychology, Department of Pediatrics, Baylor College of Medicine, 1102 Bates Avenue, Suite 940, Houston, TX 77030, USA
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295
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Loiselle K, Lee JL, Szulczewski L, Drake S, Crosby LE, Pai ALH. Systematic and Meta-Analytic Review: Medication Adherence Among Pediatric Patients With Sickle Cell Disease. J Pediatr Psychol 2015; 41:406-18. [PMID: 26384715 DOI: 10.1093/jpepsy/jsv084] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Accepted: 08/13/2015] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To provide a comprehensive summary (systematic review) of medication adherence rates by assessment method and medication type for pediatric patients with sickle cell disease (SCD), as well as identify important correlates for future research. METHODS Articles assessing medication adherence and published between 1982 and February 2015 (n = 49) were identified using electronic databases. A meta-analysis of 14 studies examining demographic, medical, and psychosocial factors and medication adherence was conducted. RESULTS Adherence rates ranged from 12% to 100% across all medications. Approximately 30% of studies reported associations between adherence and key demographic, medical, and psychosocial correlates. Mean effect sizes were small to moderate (r = .02-.53). CONCLUSIONS The wide range of adherence rates reported in the literature may be because of, in part, the use of variable assessment strategies. Future studies examining pediatric SCD adherence should incorporate key correlates with the goal of replication.
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Affiliation(s)
- Kristin Loiselle
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center
| | - Jennifer L Lee
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center
| | - Lauren Szulczewski
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center
| | - Sarah Drake
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center
| | - Lori E Crosby
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center
| | - Ahna L H Pai
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center
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296
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van Staa A, Sattoe JNT, Strating MMH. Experiences with and Outcomes of Two Interventions to Maximize Engagement of Chronically Ill Adolescents During Hospital Consultations: A Mixed Methods Study. J Pediatr Nurs 2015. [PMID: 26199096 DOI: 10.1016/j.pedn.2015.05.028] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Improving patient-provider communication during hospital consultations is advocated to enhance self-management planning and transition readiness of adolescents with chronic conditions. This longitudinal mixed methods study evaluates the implementation and the outcomes of independent split-visit consultations and individual transition plans by 22 hospital teams participating in the Dutch Action Program 'On Your Own Feet Ahead!'. The interventions raised awareness in adolescents and professionals, improved adolescents' display of independent behaviors and led to more discussions about non-medical issues. Successful implementation required a team-based approach and clear explanation to parents and adolescents. Pediatric nurses played a pivotal role in improving transitional care.
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Affiliation(s)
- AnneLoes van Staa
- Erasmus University Rotterdam, Institute of Health Policy & Management (iBMG), Rotterdam, The Netherlands; Rotterdam University of Applied Sciences, Research Centre Innovations in Care, Rotterdam, The Netherlands.
| | - Jane N T Sattoe
- Erasmus University Rotterdam, Institute of Health Policy & Management (iBMG), Rotterdam, The Netherlands; Rotterdam University of Applied Sciences, Research Centre Innovations in Care, Rotterdam, The Netherlands
| | - Mathilde M H Strating
- Erasmus University Rotterdam, Institute of Health Policy & Management (iBMG), Rotterdam, The Netherlands
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297
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Sattoe JNT, Bal MI, Roelofs PDDM, Bal R, Miedema HS, van Staa A. Self-management interventions for young people with chronic conditions: A systematic overview. PATIENT EDUCATION AND COUNSELING 2015; 98:704-715. [PMID: 25819373 DOI: 10.1016/j.pec.2015.03.004] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Revised: 11/17/2014] [Accepted: 03/07/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To provide a systematic overview of self-management interventions (SMI) for young people with chronic conditions with respect to content, formats, theories, and evaluated outcomes. METHODS Embase, Medline, PsycINFO, Web-of-Science, CINAHL, and Cochrane were searched. Reviews' reference lists were scrutinized. Selected studies were: Original research articles in English published between 2003 and March 2014; about the evaluation of SMI for 7 to 25-year-olds with somatic chronic conditions/physical disabilities; with clear outcomes and intervention descriptions. The classification of medical, role and emotion management served to review content. Formats, theories, and evaluated outcomes were summarized. RESULTS 86 studies were reviewed. Most aimed at medical management and were unclear about theoretical bases. Although a variety of outcomes was evaluated and the distribution over self-management domains was quite unpredictable, outcomes conceptually related to specific content. A content-based framework for the evaluation of self-management interventions is presented. CONCLUSIONS AND PRACTICE IMPLICATIONS SMI relate to self-management tasks and skill-building. Yet, conceptualizations of self-management support often remained unclear and content focuses predominantly on the medical domain, neglecting psycho-social challenges for chronically ill young people. Future evaluations should match outcomes/themes to content and characteristics. Our framework and overview of SMI characteristics and outcomes may assist clinicians in providing self-management support.
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Affiliation(s)
- Jane N T Sattoe
- Rotterdam University of Applied Sciences, Research Centre Innovations in Care, Rotterdam, The Netherlands; Erasmus University Rotterdam, Institute of Health Policy & Management, Rotterdam, The Netherlands.
| | - Marjolijn I Bal
- Rotterdam University of Applied Sciences, Research Centre Innovations in Care, Rotterdam, The Netherlands; Erasmus Medical University, Department of Rehabilitation Medicine, Rotterdam, The Netherlands.
| | - Pepijn D D M Roelofs
- Rotterdam University of Applied Sciences, Research Centre Innovations in Care, Rotterdam, The Netherlands.
| | - Roland Bal
- Erasmus University Rotterdam, Institute of Health Policy & Management, Rotterdam, The Netherlands.
| | - Harald S Miedema
- Rotterdam University of Applied Sciences, Research Centre Innovations in Care, Rotterdam, The Netherlands.
| | - AnneLoes van Staa
- Rotterdam University of Applied Sciences, Research Centre Innovations in Care, Rotterdam, The Netherlands; Erasmus University Rotterdam, Institute of Health Policy & Management, Rotterdam, The Netherlands.
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298
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Psihogios AM, Kolbuck V, Holmbeck GN. Condition Self-Management in Pediatric Spina Bifida: A Longitudinal Investigation of Medical Adherence, Responsibility-Sharing, and Independence Skills. J Pediatr Psychol 2015; 40:790-803. [PMID: 26002195 DOI: 10.1093/jpepsy/jsv044] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Accepted: 04/21/2015] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE This study aimed to evaluate rates of medical adherence, responsibility, and independence skills across late childhood and adolescence in youth with spina bifida (SB) and to explore associations among these disease self-management variables. METHOD 111 youth with SB, their parents, and a health professional participated at two time points. Informants completed questionnaires regarding medical adherence, responsibility-sharing, and child independence skills. RESULTS Youth gained more responsibility and independence skills across time, although adherence rates did not follow a similar trajectory. Increased child medical responsibility was related to poorer adherence, and father-reported independence skills were associated with increased child responsibility. CONCLUSIONS This study highlights medical domains that are the most difficult for families to manage (e.g., skin checks). Although youth appear to gain more autonomy across time, ongoing parental involvement in medical care may be necessary to achieve optimal adherence across adolescence.
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299
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Affiliation(s)
- Holly K M Henry
- Lucile Packard Foundation for Children's Health, Palo Alto, California
| | - Edward L Schor
- Lucile Packard Foundation for Children's Health, Palo Alto, California
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300
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Ling J, Anderson LM, Ji H. Self-management training for Chinese obese children at risk for metabolic syndrome: Effectiveness and implications for school health. SCHOOL PSYCHOLOGY INTERNATIONAL 2015. [DOI: 10.1177/0143034314564613] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This article reviews the results of a school-based self-management intervention for Chinese obese children at risk for metabolic syndrome. Twenty-eight Chinese obese children ( M age = 10 years) and their parents participated in the study. Metabolic syndrome risk factors were measured pre- and post-intervention. The risk factors included Body Mass Index, waist circumstance, systolic blood pressure, diastolic blood pressure, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, High-sensitivity C-reactive Protein, fasting plasma glucose, and fasting blood insulin. After 6 months of school-based self-management intervention, all risk factors with the exception of triglycerides and fasting plasma glucose changed significantly in the healthful direction ( p < 0.01). This pilot study offers promising implications for school interventions that are delivered by school-based practitioners collaborating with parents, teachers, and children. An individualized program based on a self-care and -management framework may have utility as a relatively cost-effective, school-based intervention to improve children’s health.
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Affiliation(s)
| | | | - Hong Ji
- Qianfoshan Hospital, P.R. China
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