Comparing Three Measures of Self-Efficacy of Asthma Self-Management in Adolescents

The effect of online peer and adult education given to adolescents with allergic asthma on their quality of life, self-efficacy, anxiety, and disease knowledge and management: a randomized controlled study

OBJECTIVE

To examine the effect of interactive online education given by peers or adults on anxiety, self-efficacy, quality of life, disease knowledge and management in adolescents with allergic asthma.

METHODS

This was a randomized controlled trial. The study sample consisted of 84 adolescents divided into experimental groups (peer education group, adult education group) and a control group. Peer and adult groups who received training were also compared with each other. The adolescents in the peer or adult education groups were given online interactive education. Data were collected from the adolescents before and immediately after education, one and three months after education.

RESULTS

The study was completed by 41 adolescents. The anxiety scores of the adolescents in the experimental groups were lower immediately and one month after education than those of the control group (p = .006; p = .012, respectively). The self-efficacy, disease knowledge and management scores of the adolescents in the experimental groups immediately after education and one and three months after education were higher than those in the control group (p < .001; p < .001; p = .015, respectively and p < .001; p < .001; p < .001, respectively). There was no difference between the groups in terms of quality of life (p > .05). No difference was found between the peer and adult groups in terms of anxiety, self-efficacy, quality of life, disease knowledge and management (p > .05).

CONCLUSION

Based on our results, peer or adult education reduced adolescents' anxiety, increased self-efficacy, and disease knowledge and management, but there was no effect on quality of life. There was no difference in measured values between the peer and adult education groups.

Turkish validity and reliability study of the adolescent asthma self-efficacy questionnaire

PURPOSE

The purpose of this study was to determine the validity and reliability of the Adolescent Asthma Self-Efficacy Questionnaire for the Turkish population.

DESIGN AND METHOD

This study involved 198 adolescents aged 12-18 who had been diagnosed with asthma. Data were collected using the Sociodemographic Information Questionnaire and the Turkish version of the Adolescent Asthma Self-Efficacy Questionnaire. The validity of the scale was evaluated using the content validity index, explanatory and confirmatory factor analyses, Cronbach's alpha reliability score, split-half method, item-total score correlation, and test-retest.

RESULTS

The Turkish version of the Adolescent Asthma Self-Efficacy Questionnaire has a total explained variance of 63%. Factor loadings were found to be higher than 0.40 in both explanatory and confirmatory factor analyses. The test-retest reliability coefficient is 0.91, and the total Cronbach's alpha value of the scale is 0.93, with all subscales having a Cronbach's alpha value >0.84. The model fit indices of the scale were found to be at an acceptable level.

CONCLUSION

The Adolescent Asthma Self-Efficacy Questionnaire is a valid and reliable measurement tool for the Turkish population.

PRACTICE IMPLICATIONS

The AASEQ can be a useful tool for healthcare professionals in the assessment of self-efficacy in adolescents who have had a diagnosis of asthma.

Assessing Available Adolescent Self-Reported Measures for Asthma Management: A Systematic Literature Review

Objective: Asthma is a common chronic disease and a substantial public health problem for children, adolescents, and adults. Adolescence, a period of increased independence and striving for autonomy, is an opportune time for youth transitioning to adulthood to assume more responsibility for their own asthma self-management. However, accurate measures of adolescent asthma outcomes are limited. The purpose of this systematic review is to identify self-reported asthma measures currently available in the empirical literature focused on adolescent populations. Methods: Search terms were based on the National Library of Medical Subject Headings and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Databases searched included CINAHL, Nursing Allied Health Prevention, Medline, ProQuest, and PubMed. Included studies were peer reviewed and published in English between 2010 and 2022. All studies reported on asthma measures for adolescents between 10 and 19 years old. Results: Nineteen studies were included, comprising 15 experimental and 4 quasi-experimental. This review revealed the following asthma measure domains: asthma knowledge, self-efficacy, attitudes, self-care, self-regulation, symptom prevention and management, medication adherence, asthma disease control, symptoms, and quality of life (QOL) for evaluating psychosocial, behavioral, clinical, and QOL outcomes. Conclusion: This review revealed the necessity of developing a comprehensive measure to assess the asthma self-management behaviors of adolescents. A comprehensive tool related to adolescent asthma self-management behavior would enhance the assessment and evaluation of adolescent asthma self-management behaviors and extend the science and clinical practice around adolescent self-management. Present measures for asthma self-management behavior for adolescents are limited; therefore, developing a valid and reliable measure is necessary not only to assess adolescents' asthma self-management behavior outcomes but also to identify and evaluate the essential components to include in educational interventions for adolescent self-management.

Psychometric validation of the Chinese version of the Adolescent Asthma Self-Efficacy Questionnaire

Background

Self-efficacy was considered as a promising target for the self-management of symptoms for adolescents with asthma. The measurement of self-efficacy in adolescents with asthma requires effective self-report tools, which have not been met with at present. So, the aim of this study was to cross-culturally validate the Adolescent Asthma Self-Efficacy Questionnaire (AASEQ).

Methods

As many as 408 adolescents with asthma were invited to take up the psychometric properties test between July 2021 and June 2022. We conducted the confirmatory factor analysis (CFA) to determine the structure of the AASEQ. The relationship between the AASEQ and General Self-Efficacy Scale was tested to evaluate the construct validity. The reliability was evaluated by retest reliability, internal consistency, and interfactor correlation.

Results

The results of the present study showed that the confirmatory factor analysis indicated a significantly good fit for a four-factor model, which explained 62.697% of the total variance. The fit indices of the four-factor model were acceptable, and the standardized factor loading ranged from 0.631 to 0.880. The C-AASEQ showed an acceptable internal consistency (Cronbach's α = 0.810-0.927) and test-retest reliability (intraclass correlation coefficient = 0.64-0.89). Content validity index at the scale level was 0.96, and content validity index at the item level was 0.86 to 1.

Conclusion

The Chinese version of Adolescent Asthma Self-Efficacy Questionnaire showed consistently acceptable positive psychometric properties and can be used as an instrument to assess the self-efficacy of adolescents with asthma in China, as corroborated in the present study.

Integrating self-efficacy in the cyclical process of paediatric asthma management: a new perspective

Asthma management consists of a cyclical process based on clinical assessment of the patient, the implementation of therapeutic adjustments, and evaluation of the patient's response. Self-efficacy is the person's confidence in his or her ability to successfully perform a behaviour and guides the patient's decisions for producing healthy behaviours.Studies have shown that asthma management is related to self-efficacy, which in turn can be influenced by various psychosocial factors. A literature search on the relationship between asthma and self-efficacy in paediatric age, has allowed us to hypothesize that adequate levels of self-efficacy might be achieved through a cyclical process, 'the self-efficacy cycle', taking into account assessment, identification of modifiable risk factors and patient's response. This would make it easier to identify the personal and social aspects on which to intervene to promote a proper management of the disease.

Using Mobile Health to Improve Asthma Self-Management in Early Adolescence: A Pilot Randomized Controlled Trial

PURPOSE

Early adolescence is an important developmental period where youth take primary responsibility for asthma self-management. Helpful caregiver support during this time is pivotal in determining whether early adolescents successfully develop asthma self-management behaviors. AIM2ACT is a dyadic mobile health intervention designed to increase helpful caregiver support as early adolescents engage in asthma self-management behaviors. We conducted a pilot randomized controlled trial to determine the feasibility and acceptability of AIM2ACT and conduct preliminary tests of efficacy.

METHODS

We randomized adolescents (12-15 years old) and a caregiver to receive AIM2ACT (n = 17) or a self-guided attention control condition (n = 16) for 20 weeks. We conducted assessment visits at baseline, postintervention, and 4-month follow-up. Outcomes included family asthma management (primary outcome), adolescent asthma control, lung function (forced expiratory volume in 1 second), asthma-related quality of life, asthma management self-efficacy, and family communication.

RESULTS

We randomized 33 dyads and had 100% retention in the trial among AIM2ACT participants. Dyads frequently engaged with AIM2ACT (M = 21 days for adolescents, 32.65 days for caregivers) and reported very high satisfaction with content, functionality, and helpfulness. Participants randomized to AIM2ACT had significant improvements in asthma control scores (p = .04) compared to control that surpassed the minimally clinically important difference threshold. Although not statistically significant, the magnitude of improvements in family asthma management, asthma-related quality of life, and family communication was larger in the AIM2ACT group.

CONCLUSIONS

AIM2ACT is a feasible and acceptable dyadic mobile health asthma self-management intervention that improves asthma control.

Long-term effects of a peer-led asthma self-management program on asthma outcomes in adolescent peer leaders

OBJECTIVE

To examine the long-term effects of a peer-led asthma self-management program on urban adolescent peer leaders with asthma.

METHODS

This longitudinal study includes 51 adolescents (16-20 years) enrolled in an asthma self-management program implemented at a one-day camp as peer leaders. Study outcomes, including quality of life, asthma control, asthma knowledge, and attitudes toward asthma were collected for 15 months post-intervention. Mixed-effects models were conducted to estimate time effects, and effect sizes were calculated for each model.

RESULTS

Of 51 enrolled, 41 completed the training, of which 35 successfully participated in the camp program. A total of 17 peer leaders withdrew between enrollment and 15-months follow-up. Quality of life, asthma control, and knowledge significantly improved after peer leader training and remained elevated for 15 months, while significant improvement in attitudes emerged immediately after camp, in which they served as leaders, and sustained for 15 months.

CONCLUSION

This study demonstrates the long-term positive effects of a peer-led program on a wide range of asthma outcomes in urban adolescent peer leaders.

PRACTICE IMPLICATIONS

A peer-led approach to asthma education providing peer leaders with intense training and leadership experience can be effective and sustainable in improving asthma outcomes among urban adolescents.