Factors Associated With Nonresponse to a Computer-Tailored Asthma Management Program for Urban Adolescents With Asthma
Open accessAbstract
BACKGROUND: The ability to identify potentially resistant participants early in the course of an intervention could inform development of strategies for behavior change and improve program effectiveness. OBJECTIVE: The objective of this analysis was to identify factors related to nonresponse (i.e., lack of behavior change) to an asthma management intervention for urban teenagers. The intervention targeted several behaviors, including medication adherence, having a rescue inhaler nearby, and smoking. METHODS: A discriminate analysis was conducted using data from a randomized trial of the intervention. Included in this analysis are participants who reported a physician diagnosis of asthma, completed a baseline questionnaire, were randomized to the treatment group, completed >or=2 of 4 educational sessions, and completed >or=2 of 3 follow-up questionnaires. Ninety students met criteria for inclusion in this subgroup analysis. RESULTS: In logistic regression models for medication adherence, nonresponse was related to low baseline asthma self-regulation, odds ratio = 3.6 (95% confidence interval = 1.3-9.5). In models for having an inhaler nearby, nonresponse was related to low baseline self-regulation and to rebelliousness, OR = 4.7 (1.6-13.2) and 5.6 (1.7-18.0), respectively. Nonresponse to smoking messages was related to rebelliousness, low emotional support, and low religiosity, ORs = 7.6 (1.8-32.3), 9.5 (1.4-63.5), and 6.6 (1.5-29.8) respectively. CONCLUSIONS: Certain variables had the ability to discriminate the likelihood of response from that of nonresponse to an asthma program for urban, African American adolescents with asthma. These variables can be used to identify resistant subgroups early in the intervention, allowing the application of specialized strategies through tailoring. These types of analyses can inform behavioral interventions.
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Patients who may struggle to benefit from health behavior interventions like MI include those with low expectation of improvement, low overall optimism, and low perceived social support.
“There appear to be specific characteristics of patients who may struggle to benefit from health behavior interventions like MI, such as those who have low expectation of improvement and low overall optimism and those who have low perceived social support [118–120].”
From Positive Psychological Interventions for Patients with Type 2 Diabetes: Rationale, Theoretical Model, and Intervention Development (2015) · cites this paper as [120]
These individual and social-level constructs have been associated with greater efficacy and impact of MI and other health behavior interventions.
“These individual and social-level constructs, in turn, have been associated with greater efficacy and impact of MI and other health behavior interventions (pathway A2) [118–120, 129, 130].”
From Positive Psychological Interventions for Patients with Type 2 Diabetes: Rationale, Theoretical Model, and Intervention Development (2015) · cites this paper as [120]
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- Authors
- Joseph, C. L. M., Havstad, S. L., Johnson, D., Saltzgaber, J., Peterson, E. L., Resnicow, K., Ownby, D. R., Baptist, A. P., Johnson, C. C., & Strecher, V. J.
- Affiliations
- Henry Ford Health (US)
- University of Michigan (US)
- Augusta University (US)
- Michigan Medicine (US)
- Corresponding author
- Joseph, C. L. M.
- ORCID
- Venue
- Journal of Asthma
- Publisher
- Informa UK Limited
- Published
- 2010-07-20
- Volume
- 47
- Issue
- 6
- Pages
- 667-673
- ISSN
- 0277-0903 (ISSN-L)
- 1532-4303
- PMC
- PMC4017358
- OpenAlex
- W1993639447
- Cited by
- 28
- References
- 50
- Citations by year
- 2023: 1 · 2020: 3 · 2019: 2 · 2018: 6 · 2017: 4 · 2016: 2 · 2015: 4 · 2014: 1 · 2013: 1 · 2012: 2
- FWCI
- 1.08
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Journal of Asthma (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Heart, Lung, and Blood Institute (R01HL068971, HL068971)
- Topics
- Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Keywords
- computer-tailored intervention, adolescents, urban youth, African American adolescents, medication adherence, rescue inhaler use, smoking, rebelliousness, emotional support, religiosity, behavior change
- MeSH terms
- Adolescent, Asthma, Behavior Therapy, Black or African American, Female, Humans, Male, Michigan, Models, Psychological, Patient Compliance, Patient Education as Topic, Smoking, Software, Urban Population, Logistic Models, Anti-Asthmatic Agents
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