Family Support is Associated with Fewer Adherence Barriers and Greater Intent to Adhere to Oral Medications in Pediatric IBD
Abstract
Purpose Medication nonadherence is common among adolescents, and family support can enhance adherence. In a sample of youth with inflammatory bowel disease (IBD), we aimed to describe barriers to oral medication adherence and intent to adhere. Additionally, we examined the role of family support in influencing adherence barriers and intent to adhere, and assessed if age moderated these relationships.Designs and methods A secondary analysis of baseline data from an adherence-promotion intervention trial was conducted. Youth reported perceptions of family support, adherence barriers, and intent to adhere via validated measures.Results Among youth (N = 76, ages 11-18), age moderated the impact of family support on total adherence barriers, disease/regimen barriers, social support/self-efficacy barriers, and intent to adhere. At higher levels of family support, younger (M age = 12.93 years) and mid-age (M age = 14.68 years) youth reported fewer barriers to adherence and greater intent to adhere. No main effect of family support or evidence of age moderation was found for denial/distrust or peer influences barrier domains.Conclusions Younger and mid-aged adolescents benefitted from family support in the context of IBD management. Future research should examine whether interventions to enhance family support may enhance youth adherence.Practical implications Given prior findings highlighting the success of nurse-led interventions in promoting adherence in patients with IBD, present findings suggest additional intervention points for nurses working with pediatric IBD populations.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Patients with IBD and comorbid depression and/or anxiety may be less likely to adhere to medical care procedures and therapeutic schemes, resulting in unnecessary escalation in therapy and complications.
“patients with IBD and co-morbid depression and/or anxiety may be less likely to adhere to medical care procedures and therapeutic schemes, resulting in unnecessary escalation in therapy and complications [50,51,52].”
From Association between Childhood Onset Inflammatory Bowel Disease and Psychiatric Comorbidities in Adulthood (2023) · cites this paper as [51]
Cites
Making sense of cronbach’s alpha.
Tavakol, M., & Dennick, R. (2011) · International Journal of Medical Education · doi:10.5116/ijme.4dfb.8dfd · Cited by 15,126 · see citing works
The Multidimensional Scale of Perceived Social Support
Zimet, G. D., Dahlem, N. W., Zimet, S. G., & Farley, G. K. (1988) · Journal of Personality Assessment · doi:10.1207/s15327752jpa5201_2 · Cited by 13,339 · see citing works
Introduction to mediation, moderation, and conditional process analysis :
Hayes, A. F., & names (2015) · Cited by 7,004 · see citing works
Polonsky, W., & Henry, R. (2016) · Patient Preference and Adherence · doi:10.2147/ppa.s106821 · Cited by 784 · see citing works
Epidemiology of inflammatory bowel disease
Loftus, E. V., & Sandborn, W. J. (2002) · Gastroenterology Clinics of North America · doi:10.1016/s0889-8553(01)00002-4 · Cited by 542 · see citing works
Assessing Family Sharing of Diabetes Responsibilities
Anderson, B. J., Auslander, W., Jung, K. C., Miller, J. P., & Santiago, J. V. (1990) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/15.4.477 · Cited by 496 · see citing works
Bokhorst, C. L., Sumter, S. R., & Westenberg, P. M. (2009) · Social Development · doi:10.1111/j.1467-9507.2009.00540.x · Cited by 490 · see citing works
Adherence to Pediatric Medical Regimens
Rapoff, M. A. (1999) · Springer eBooks · doi:10.1007/b102349 · Cited by 357 · see citing works
Beyond statistical significance: clinical interpretation of rehabilitation research literature.
Page, P. (2014) · PubMed Central · Cited by 343 · see citing works
How to address non-normality: a taxonomy of approaches, reviewed, and illustrated
Pek, J., Wong, O., & Wong, A. C. M. (2018) · Frontiers in Psychology · doi:10.3389/fpsyg.2018.02104 · Cited by 307 · see citing works
Wysocki, T., Harris, M. A., Buckloh, L. M., Mertlich, D., Lochrie, A. S., Taylor, A., Sadler, M., Mauras, N., & White, N. H. (2006) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsj098 · Cited by 299 · see citing works
Wysocki, T. (2000) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/25.1.23 · Cited by 269 · see citing works
Hanauer, S., SCHWARTZ, J., ROBINSON, M. G., Roufail, W. M., Arora, S., Cello, J. P., & Safdi, M. A. (1993) · PubMed · Cited by 266 · see citing works
Patient Perspective on Factors Contributing to Nonadherence to Diabetes Regimen
Ary, D. V., Toobert, D. J., Wilson, W., & Glasgow, R. E. (1986) · Diabetes Care · doi:10.2337/diacare.9.2.168 · Cited by 182 · see citing works
Palmer, D. L. (2004) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsh005 · Cited by 172 · see citing works
Cognitive maturity and self-management among adolescents with insulin-dependent diabetes mellitus
Ingersoll, G. M., Orr, D. P., Herrold, A. J., & Golden, M. P. (1986) · The Journal of Pediatrics · doi:10.1016/s0022-3476(86)80852-6 · Cited by 144 · see citing works
Gray, W. N., Denson, L. A., Baldassano, R. N., & Hommel, K. A. (2012) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsr092 · Cited by 143 · see citing works
The Illness Management Survey: Identifying Adolescents' Perceptions of Barriers to Adherence
Logan, D. E. (2003) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsg028 · Cited by 132 · see citing works
BEARMAN, K. J. (2002) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/27.5.417 · Cited by 131 · see citing works
Oral Medication Adherence in Pediatric Inflammatory Bowel Disease
Mackner, L. M., & Crandall, W. (2005) · Inflammatory Bowel Diseases · doi:10.1097/01.mib.0000186409.15392.54 · Cited by 121 · see citing works
Family Structure and the Development of Autonomy During Adolescence
Sessa, F. M., & Steinberg, L. D. (1991) · The Journal of Early Adolescence · doi:10.1177/0272431691111003 · Cited by 117 · see citing works
Non‐adherence in pediatric transplantation: A review of the existing literature
Griffin, K. J., & Elkin, T. D. (2001) · Pediatric Transplantation · doi:10.1034/j.1399-3046.2001.005004246.x · Cited by 101 · see citing works
Barriers to Oral Medication Adherence for Adolescents with Inflammatory Bowel Disease
Ingerski, L. M., Baldassano, R. N., Denson, L. A., & Hommel, K. A. (2009) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsp085 · Cited by 93 · see citing works
Prevalence, predictors, and clinical consequences of medical adherence in IBD: How to improve it?
Lakatos, P. L. (2009) · World Journal of Gastroenterology · doi:10.3748/wjg.15.4234 · Cited by 87 · see citing works
Brief Report: Barriers to Treatment Adherence in Pediatric Inflammatory Bowel Disease
Hommel, K. A., & Baldassano, R. N. (2009) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsp126 · Cited by 81 · see citing works
Barriers to adherence among adolescents with inflammatory bowel disease
Greenley, R. N., Stephens, M., Doughty, A., Raboin, T., & Kugathasan, S. (2009) · Inflammatory Bowel Diseases · doi:10.1002/ibd.20988 · Cited by 77 · see citing works
Family Support and Asthma Outcomes in Adolescents: Barriers to Adherence as a Mediator
Rhee, H., Belyea, M. J., & Brasch, J. D. (2010) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2010.03.009 · Cited by 76 · see citing works
Epidemiology of Inflammatory Bowel Disease – 1985
Gilat, T. (1986) · Springer eBooks · doi:10.1007/978-94-009-4269-1_6 · Cited by 67 · see citing works
The Beliefs About Medication Scale: Development, Reliability, and Validity
Riekert, K. A., & Drotar, D. (2002) · Journal of Clinical Psychology in Medical Settings · doi:10.1023/a:1014900328444 · Cited by 67 · see citing works
Helper, D. J., & Rex, D. (2001) · Endoscopy · doi:10.1055/s-2001-11668 · Cited by 65 · see citing works
Rates and Predictors of Oral Medication Adherence in Pediatric Patients with IBD
LeLeiko, N. S., Lobato, D. J., Hagin, S., McQuaid, E. L., Seifer, R., Kopel, S. J., Boergers, J., Nassau, J. H., Suorsa, K. I., Shapiro, J. M., et al. (2013) · Inflammatory Bowel Diseases · doi:10.1097/mib.0b013e3182802b57 · Cited by 63 · see citing works
Greenley, R. N., Gumidyala, A. P., Nguyen, E., Plevinsky, J. M., Poulopoulos, N., Thomason, M. M., Walter, J. G., Wojtowicz, A. A., Blank, E., Gokhale, R., et al. (2015) · Inflammatory Bowel Diseases · doi:10.1097/mib.0000000000000530 · Cited by 61 · see citing works
Telephone nurse counseling for medication adherence in ulcerative colitis: A preliminary study
Cook, P. F., Emiliozzi, S., Hajj, D. E., & McCabe, M. M. (2010) · Patient Education and Counseling · doi:10.1016/j.pec.2009.12.010 · Cited by 61 · see citing works
Perceived Self-Efficacy and Phobic Disability
Williams, S. L. (2014) · Taylor & Francis eBooks · doi:10.4324/9781315800820-10 · Cited by 51 · see citing works
Young, J. W., & Ferguson, L. R. (1979) · Journal of Youth and Adolescence · doi:10.1007/bf02087623 · Cited by 47 · see citing works
Heart or heart–lung transplantation: Psychosocial outcome
Serrano-Ikkos, E., Lask, B. D., Whitehead, B., Rees, P., & Graham, P. (1999) · Pediatric Transplantation · doi:10.1034/j.1399-3046.1999.00059.x · Cited by 40 · see citing works
Janicke, D. M., Gray, W. N., Kahhan, N. A., Junger, K. W., Marciel, K. K., Storch, E. A., & Jolley, C. D. (2008) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsn116 · Cited by 35 · see citing works
Butler, A. E., Hall, H. G., & Copnell, B. (2018) · Journal of Pediatric Nursing · doi:10.1016/j.pedn.2018.02.002 · Cited by 33 · see citing works
Nearchou, F., Davies, A., & Hennessy, E. (2019) · Irish Journal of Psychological Medicine · doi:10.1017/ipm.2019.54 · Cited by 17 · see citing works
Reed, B., Lewis, J. D., & Blount, R. L. (2012) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jss122 · Cited by 16 · see citing works
Intent‐to‐Adhere and Adherence to Malaria Prevention Recommendations in Two Travel Clinics: Table 1
Goldstein, I., Grefat, R., Ephros, M. A., & Rishpon, S. (2014) · Journal of Travel Medicine · doi:10.1111/jtm.12156 · Cited by 14 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Sălcudean, A., Nan, A. G., Bodo, C. R., Cosma, M. C., Strete, E. G., & Lica, M. M. (2023) · Diagnostics · doi:10.3390/diagnostics13111868 · Cited by 24 · see citing works
Wühl, E., Calpe, J., Drożdż, D., Erdine, S. E., Fernández‐Aranda, F., Hadjipanayis, A., Hoyer, P. F., Jankauskienė, A., Jiménez‐Múrcia, S., Litwin, M., et al. (2023) · Frontiers in Pediatrics · doi:10.3389/fped.2023.1140617 · Cited by 17 · see citing works
Wu, Q., Zhu, P., Liu, X., Ji, Q., & Qian, M. (2022) · Children · doi:10.3390/children9060879 · Cited by 10 · see citing works
Spitaletta, G., Biagioli, V., Greco, F., Mascolo, R., Liburdi, A., Manzi, G., Gawronski, O., Ricci, R., Tiozzo, E., Vellone, E., et al. (2023) · Frontiers in Pediatrics · doi:10.3389/fped.2023.1170268 · Cited by 7 · see citing works
Isotretinoin Concerns in Switzerland: A Student-Based Transversal Study
Jakobi, A.-L. U., Bircher, A. J., Pagnamenta, A., & Terrani, I. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14061801 · Cited by 4 · see citing works
Kaul, K., Schumann, S., Felder, J., Däbritz, J., & de Laffolie, J. (2025) · Children · doi:10.3390/children12050620 · Cited by 4 · see citing works
Liang, F., Yu, H., Li, F., & Li, X. (2025) · Frontiers in Public Health · doi:10.3389/fpubh.2025.1685991 · Cited by 3 · see citing works
Storch, B., & Reigada, L. C. (2024) · Translational Gastroenterology and Hepatology · doi:10.21037/tgh-24-2 · Cited by 3 · see citing works
Fang, X., Jia, Y., Zhou, Y., Yang, Z., Guo, R., Cheng, Y., Cheng, Y., Zeng, R., Wan, Z., Zhao, Q., et al. (2025) · Journal of Clinical Hypertension · doi:10.1111/jch.70107 · Cited by 3 · see citing works
Yang, M., Lei, L., An, H., Shi, L., He, Y., Yang, M., Peng, L., Li, L., Ding, X., & Luo, X. (2026) · Frontiers in Nutrition · doi:10.3389/fnut.2025.1704658 · Cited by 2 · see citing works
Liu, Y., Hu, Y., Zheng, J., & Wu, Z. (2026) · Journal of Inflammation Research · doi:10.2147/jir.s594782 · Cited by 2 · see citing works
Mangopang, D., Nulhakim, L., & Raihanah, S. (2022) · Formosa Journal of Science and Technology · doi:10.55927/fjst.v1i8.1968 · Cited by 2 · see citing works
Winberg, D., Panchang, S. V., Nauman, E., Mohundro, B. L., Tang, T., Price‐Haywood, E. G., Onufrak, S. J., Shi, L., & Bazzano, A. N. (2026) · Patient Preference and Adherence · doi:10.2147/ppa.s596366 · Cited by 1 · see citing works
de Gooyer, M., Mackay, M. I., Mikocka‐Walus, A. A., Biurra, Y. C., Emerson, C., Klas, A., Raven, L., Massuger, W., Giles, E. M., & Evans, S. (2026) · British Journal of Health Psychology · doi:10.1111/bjhp.70079 · Cited by 1 · see citing works
Christian, B. J. (2021) · Journal of Pediatric Nursing · doi:10.1016/j.pedn.2021.08.021 · Cited by 1 · see citing works
Iijima, A., & Yanagisawa, S. (2024) · Journal of Japan Academy of Nursing Science · doi:10.5630/jans.44.1117
Zhang, J., Ren, S.-R., Ding, W., & Jiefeng, Y. (2026) · Frontiers in Pediatrics · doi:10.3389/fped.2026.1754064
Wang, Y., Chen, Y., Dong, Q., Gao, X., & Jiang, B. (2026) · BMC Women s Health · doi:10.1186/s12905-026-04699-2
Zhu, Z.-R., Zhao, X., Wang, C.-C., Ding, J., & He, Y. (2026) · Frontiers in Medicine · doi:10.3389/fmed.2026.1857587
- Authors
- Feldman, E. C. H., Durkin, L. K., & Greenley, R. N.
- Affiliations
- Rosalind Franklin University of Medicine and Science (US)
- Corresponding author
- Feldman, Estée C.H.
- Venue
- Journal of Pediatric Nursing
- Publisher
- Elsevier BV
- Published
- 2021-09
- Volume
- 60
- Pages
- 58-64
- ISSN
- 0882-5963 (ISSN-L)
- OpenAlex
- W3131986263
- Cited by
- 19
- References
- 41
- Citations by year
- 2026: 7 · 2025: 4 · 2024: 2 · 2023: 3 · 2022: 2 · 2021: 1
- FWCI
- 2.15
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Journal of Pediatric Nursing (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Crohn's and Colitis Foundation of America (NCT01237847, 2838)
- Topics
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Health Sciences › Health Professions › Speech and Hearing › Adolescent and Pediatric Healthcare
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmacy and Medical Practices
- Keywords
- pediatric inflammatory bowel disease, medication adherence, family support, barriers to adherence, adolescents, age moderation, self-efficacy, social support, nurse-led intervention
- MeSH terms
- Adolescent, Child, Humans, Middle Aged, Inflammatory Bowel Diseases, Intention, Medication Adherence
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
