Understanding Treatment Adherence With the Health Belief Model in Children With Cystic Fibrosis.

OBJECTIVE: Children's health beliefs are significantly related to their adherence; however, pediatric literature has rarely tested health-related theories as a whole. The goal of the present study was to evaluate the use of the health belief model (HBM) in understanding children's adherence, both globally and to individual treatment components. METHOD: Thirty-three patient-parent dyads completed questionnaires regarding health beliefs and adherence to medical regimens. RESULTS: Multiple linear regressions found a significant relationship among the HBM variables and reports of global adherence for children and parents. For children, the HBM variables were significantly related to adherence to aerosol medications, aerosol antibiotics, metered dose inhalers, and vitamins. For parents, the HBM variables were significantly related to children's adherence to airway clearance, oral antibiotics, and vitamins. Paired sample t tests found children and parents had significantly discrepant heath beliefs. CONCLUSION: These findings provide further support for the HBM in evaluating pediatric adherence, with evidence that barriers and cues to action may be targets for early intervention. Future research using this model to identify a comprehensive way to assess, understand, and elicit change in the adherence to medical regimens for youth with chronic illness would be beneficial.

Impact of age and gender on adherence to infection control guidelines and medical regimens in cystic fibrosis.

RATIONALE: The goal of the present research was to examine the impact of age and gender on adherence to both infection control (IC) guidelines and traditional medical treatments in a cystic fibrosis (CF) population. Adherence behaviors are consistently suboptimal in chronic illness populations, particularly pulmonary diseases; understanding the factors related to adherence behaviors in CF can aid in the development of interventions to promote adherence. METHOD: Participants consisted of 74 individuals with CF ages 9 years and above. Participants were asked to complete questionnaires designed to assess demographic data, treatment adherence, and health beliefs. RESULTS: With respect to IC guidelines, chi-square analyses revealed significant age differences in adherence behaviors such that the young adult subsample was least adherent to IC (χ2 = 15.10, df = 6, P = 0.020). Next, a 4 (age: child, adolescent, young adult, adult) × 2 (gender) completely between subjects analysis of variance (ANOVA) was conducted on medical treatment adherence. There was a significant main effect for age [F(3, 65) = 2.940, P = 0.040, ηP2 = 0.119] indicating that the adolescent subsample had the most adherence challenges. Gender was nonsignificant across both adherence types. CONCLUSIONS: Study findings are suggestive of age-related differences in adherence behaviors across both IC and medical regimens and support the use of developmentally sensitive approaches to assessment and interventions addressing adherence.