Improving self-management in adolescents with sickle cell disease.
AYA
disease knowledge
disease management
health motivation
patient activation
self-efficacy
Journal
Pediatric blood & cancer
ISSN: 1545-5017
Titre abrégé: Pediatr Blood Cancer
Pays: United States
ID NLM: 101186624
Informations de publication
Date de publication:
10 2020
10 2020
Historique:
received:
31
12
2019
revised:
29
04
2020
accepted:
24
05
2020
pubmed:
23
7
2020
medline:
5
1
2021
entrez:
23
7
2020
Statut:
ppublish
Résumé
Sickle cell disease (SCD) is associated with significant medical challenges that often worsen in adolescence when caregivers are beginning to transfer responsibility for disease management. Behavioral activation (BA) is an important precedent to improvements in self-management and ultimately health outcomes; however, few interventions targeting BA have been developed for the SCD population. The goal of the present study was to evaluate a technology-enhanced self-management intervention for adolescents and young adults (AYA) with SCD targeting BA domains (ie, disease knowledge, self-efficacy, motivation, and self-management skills). Participants were randomized to one of two study arms. SCThrive participants (N = 26) completed six weekly group sessions, an in-person booster session, and used a companion app (iManage) to record symptoms, progress on goals, and connect with other group members. Each SCHealthEd participant (N = 27) received six weekly phone calls on SCD-related and general health education topics. All AYA completed questionnaires assessing BA at baseline and posttreatment. Separate mixed ANOVA analyses to assess for the effects of group (SCThrive/SCHealthEd), time (baseline/posttreatment), and group × time interaction indicated that there was a clinically meaningful improvement (8-point change) in self-efficacy, with a medium effect size, P = .09, η The results support the potential for a self-management intervention to improve self-efficacy in AYA with SCD. Health care providers are encouraged to target BA skills to support self-management of AYA with SCD.
Sections du résumé
BACKGROUND
Sickle cell disease (SCD) is associated with significant medical challenges that often worsen in adolescence when caregivers are beginning to transfer responsibility for disease management. Behavioral activation (BA) is an important precedent to improvements in self-management and ultimately health outcomes; however, few interventions targeting BA have been developed for the SCD population. The goal of the present study was to evaluate a technology-enhanced self-management intervention for adolescents and young adults (AYA) with SCD targeting BA domains (ie, disease knowledge, self-efficacy, motivation, and self-management skills).
DESIGN/METHODS
Participants were randomized to one of two study arms. SCThrive participants (N = 26) completed six weekly group sessions, an in-person booster session, and used a companion app (iManage) to record symptoms, progress on goals, and connect with other group members. Each SCHealthEd participant (N = 27) received six weekly phone calls on SCD-related and general health education topics. All AYA completed questionnaires assessing BA at baseline and posttreatment.
RESULTS
Separate mixed ANOVA analyses to assess for the effects of group (SCThrive/SCHealthEd), time (baseline/posttreatment), and group × time interaction indicated that there was a clinically meaningful improvement (8-point change) in self-efficacy, with a medium effect size, P = .09, η
CONCLUSIONS
The results support the potential for a self-management intervention to improve self-efficacy in AYA with SCD. Health care providers are encouraged to target BA skills to support self-management of AYA with SCD.
Identifiants
pubmed: 32697889
doi: 10.1002/pbc.28492
pmc: PMC7722105
mid: NIHMS1628660
doi:
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
e28492Subventions
Organisme : NICHD NIH HHS
ID : R21HD084810
Pays : United States
Organisme : NHLBI NIH HHS
ID : F32 HL143915
Pays : United States
Organisme : NICHD NIH HHS
ID : R21 HD084810
Pays : United States
Organisme : NHLBI NIH HHS
ID : 1F32HL143915
Pays : United States
Organisme : NCATS NIH HHS
ID : 2UL1TR001425-05A1
Pays : United States
Informations de copyright
© 2020 Wiley Periodicals LLC.
Références
J Pediatr Psychol. 2004 Apr-May;29(3):197-209
pubmed: 15131137
J Adolesc Health. 2017 Jan;60(1):120-123
pubmed: 27793727
Int J Behav Med. 1997;4(4):364-77
pubmed: 16250724
J Child Adolesc Psychiatr Nurs. 2008 Aug;21(3):177-85
pubmed: 18667050
JAMA. 2010 Apr 7;303(13):1288-94
pubmed: 20371788
J Pain. 2017 May;18(5):490-498
pubmed: 28065813
Health Serv Res. 2005 Dec;40(6 Pt 1):1918-30
pubmed: 16336556
Pediatr Nurs. 2007 Jan-Feb;33(1):60-3, 72
pubmed: 17411004
JMIR Mhealth Uhealth. 2017 Apr 19;5(4):e50
pubmed: 28428157
Health Educ Res. 2007 Oct;22(5):691-702
pubmed: 17138613
Pediatr Blood Cancer. 2019 Oct;66(10):e27899
pubmed: 31267645
J Pediatr Hematol Oncol. 2015 Nov;37(8):577-83
pubmed: 26492583
Health Qual Life Outcomes. 2012 Nov 16;10:134
pubmed: 23158687
Pediatrics. 2012 Feb;129(2):e473-85
pubmed: 22218838
J Pediatr Psychol. 2011 Mar;36(2):160-71
pubmed: 20040605
J Pediatr Psychol. 2015 Nov-Dec;40(10):1085-94
pubmed: 26136404
Curr Probl Pediatr Adolesc Health Care. 2006 Nov-Dec;36(10):346-76
pubmed: 17055417
Pediatrics. 2012 Nov;130(5):926-35
pubmed: 23027174
J Pain. 2019 Jul;20(7):746-759
pubmed: 30578848
Curr Psychiatry Rep. 2007 Apr;9(2):114-21
pubmed: 17389120
Psychosom Med. 2001 Sep-Oct;63(5):850-8
pubmed: 11573035
Adv Ther. 2015 Apr;32(4):293-305
pubmed: 25832469
Pediatr Blood Cancer. 2017 Jan;64(1):139-145
pubmed: 27574031
Int J Adolesc Med Health. 2005 Apr-Jun;17(2):169-78
pubmed: 15971736
Pain Manag Nurs. 2015 Jun;16(3):418-24
pubmed: 25047808
J Natl Black Nurses Assoc. 2001 Dec;12(2):6-14
pubmed: 11902023
South Online J Nurs Res. 2011 Apr;11(1):
pubmed: 21769284
J Pediatr Psychol. 2008 Jul;33(6):590-611
pubmed: 18192300
J Adolesc Health. 2011 Mar;48(3):295-302
pubmed: 21338902
Am J Occup Ther. 2015 Mar-Apr;69(2):6902350030p1-5
pubmed: 26122692
Res Nurs Health. 2008 Aug;31(4):355-69
pubmed: 18247376
Pediatr Blood Cancer. 2009 Jul;52(7):838-41
pubmed: 19229973
Ren Fail. 2012;34(6):744-53
pubmed: 22583152
J Gen Intern Med. 2012 May;27(5):520-6
pubmed: 22127797
BMJ. 2003 Jun 14;326(7402):1308-9
pubmed: 12805167
J Pain. 2008 Sep;9(9):833-40
pubmed: 18550443
Pediatr Blood Cancer. 2013 Aug;60(8):1338-44
pubmed: 23441057
J Pediatr Psychol. 2019 Sep 1;44(8):937-947
pubmed: 31069392
Health Qual Life Outcomes. 2008 Aug 09;6:60
pubmed: 18691422
Am J Hematol. 2011 Jan;86(1):116-20
pubmed: 21061308
Qual Life Res. 2012 Mar;21(2):341-57
pubmed: 21638090
Clin Pract Pediatr Psychol. 2014 Dec 1;4(2):389-399
pubmed: 25664228