Betsy Sleath, Ph.D., Principal Investigator
This four-year project, funded by the National Heart, Lung, and Blood Institute, is focused on a neglected area within children’s health services research, the relationship between provider-child-caregiver communication during pediatric asthma visits and treatment adherence. Treatment adherence comprises medication adherence, symptom monitoring, and environmental trigger control. Thirty-five physicians and their nurses and 360 English-speaking child-caregiver pairs will be recruited at eight private pediatric clinics. Children with asthma will be eligible if they are between 8 and 15 years of age, have mild, moderate, or severe persistent asthma, and have previously visited this physician at least twice before for asthma. Caregivers will be eligible if they are at least 18 years of age and live with the child with asthma. Consent and assent to participate will be obtained from the caregivers and children respectively. Physicians and nurses will fill out a demographic questionnaire at the start of the study. The children will have their health care provider visits audio-tape recorded. The children will be interviewed after their visits. The children’s caregivers will fill out questionnaires after these visits. A home visit will occur one month after the audio-taped visit. Lung function testing using spirometry will occur after the audio-taped visit and at the home visit one month later. Children will be interviewed during the home visits and their caregivers will fill out questionnaires. Generalized estimating equations will be used to examine how physician and nurse communication about asthma management, modeling of asthma care behaviors, and engagement of the child and caregiver during medical visits, are related to treatment adherence.