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Self-Determination Theory and Preventive Medication Adherence: Motivational Considerations to Support Historically Marginalized Adolescents With Asthma

      ABSTRACT

      Introduction

      Using self-determination theory, we explored relationships between autonomous motivation (AM) and perceived competence (PC) with previously validated measures of motivation and adolescent-reported asthma medication adherence.

      Method

      Data were from adolescents (n = 260) enrolled in the School-Based Asthma Care for Teens study and taking preventive medication at baseline. Eligible adolescents (aged 12–16 years) had physician-diagnosed persistent asthma or poor control.

      Results

      Adolescents taking daily preventive medicine reported higher AM and PC for adherence, whereas adolescents likely to miss ≥1 dose in the next 2 weeks had lower AM and PC. Adolescents taking medicines as prescribed, with plans to continue, and those feeling able to follow provider care plans, had higher AM and PC. Findings remained significant in regressions with control variables.

      Discussion

      Many factors interfere with adolescent medication-taking. Clinicians’ efforts to build AM and PC with patients and caregivers may be key to promoting adherence in this group.

      Keywords

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      References

        • Akinbami L.J.
        • Moorman J.E.
        • Bailey C.
        • Zahran H.S.
        • King M.
        • Johnson C.A.
        • Liu X.
        Trends in asthma prevalence, health care use, and mortality in the United States, 2001–2010.
        NCHS Data Brief. 2012; 94: 1-8
        • Akinbami L.J.
        • Moorman J.E.
        • Simon A.E.
        • Schoendorf K.C.
        Trends in racial disparities for asthma outcomes among children 0 to 17 years, 2001–2010.
        Journal of Allergy and Clinical Immunology. 2014; 134 (e5): 547-553
        • Bender B.G.
        Overcoming barriers to nonadherence in asthma treatment.
        Journal of Allergy and Clinical Immunology. 2002; 109: S554-S559
        • Bingham P.M.
        • Crane I.
        • Manning S.W.
        Illness experience, self-determination, and recreational activities in pediatric asthma.
        Games for Health Journal. 2017; 6: 179-186
        • Blaakman S.W.
        • Cohen A.
        • Fagnano M.
        • Halterman J.S.
        Asthma medication adherence among urban teens: A qualitative analysis of barriers, facilitators and experiences with school-based care.
        Journal of Asthma. 2014; 51: 522-529
        • Borrelli B.
        • Tooley E.M.
        • Scott-Sheldon L.A.
        Motivational interviewing for parent–child health interventions: A systematic review and meta-analysis.
        Pediatric Dentistry. 2015; 37: 254-265
        • Bruzzese J.M.
        • Bonner S.
        • Vincent E.J.
        • Sheares B.J.
        • Mellins R.B.
        • Levison M.J.
        • Evans D.
        Asthma education: The adolescent experience.
        Patient Education and Counseling. 2004; 55: 396-406
        • Bruzzese J.M.
        • Idalski Carcone A.
        • Lam P.
        • Ellis D.A.
        • Naar-King S.
        Adherence to asthma medication regimens in urban African American adolescents: Application of self-determination theory.
        Health Psychology. 2014; 33: 461-464
        • Burg G.T.
        • Covar R.
        • Oland A.A.
        • Guilbert T.W.
        The tempest: Difficult to control asthma in adolescence.
        Journal of Allergy and Clinical Immunology. in Practice. 2018; 6: 738-748
        • Buttitta M.
        • Rousseau A.
        • Guerrien A.
        A new understanding of quality of life in children and adolescents with obesity: Contribution of the self-determination theory.
        Current Obesity Reports. 2017; 6: 432-437
        • Caruso A.
        • Grolnick W.
        • Rabner J.
        • Lebel A.
        Parenting, self-regulation, and treatment adherence in pediatric chronic headache: A self-determination theory perspective.
        Journal of Health Psychology. 2021; 26: 1637-1650
      1. Center for Self-Determination Theory. (2021). Health-care self-determination theory questionnaire. Retrieved from: https://selfdeterminationtheory.org/health-care-self-determination-theory/

      2. Centers for Disease Control and Prevention. (2021). Tools for putting Social Determinants of Health into action. Retrieved from: https://www.cdc.gov/socialdeterminants/tools/index.htm

        • Chen C.
        • Zhang T.
        • Gu X.
        • Lee J.
        • Ren S.
        • Wang H.
        Understanding adolescents’ need support, need satisfaction, and health-related outcomes: A self-determination health behavior perspective.
        International Journal of Environmental Research and Public Health. 2019; 17: 104
        • Cloutier M.M.
        • Dixon A.E.
        • Krishnan J.A.
        • Lemanske R.F.
        • Pace W.
        • Schatz M.
        Managing asthma in adolescents and adults: 2020 asthma guideline update from the national asthma education and prevention program.
        Journal of the American Medical Association. 2020; 324: 2301-2317
        • Deci E.L.
        • Ryan R.M.
        The “what” and “why” of goal pursuits: Human needs and the self-determination of behavior.
        Psychological Inquiry. 2000; 11: 227-268
        • Denman D.C.
        • Baldwin A.S.
        • Marks E.G.
        • Lee S.C.
        • Tiro J.A.
        Modification and validation of the Treatment Self Regulation Questionnaire to assess parental motivation for HPV vaccination of adolescents.
        Vaccine. 2016; 34: 4985-4990
        • Desai M.
        • Oppenheimer J.J.
        Medication adherence in the asthmatic child and adolescent.
        Current Allergy and Asthma Reports. 2011; 11: 454-464
        • Duprez V.
        • Haerens L.
        • Wuyts D.
        • Verhaeghe S.
        • van Zanten R.
        • Massey E.K.
        • Van Hecke A.
        Self-Determination Theory to observe healthcare professionals’ counselling in chronic care encounters: Development of the COUNSEL-CCE tool.
        Patient Education and Counseling. 2021; 104: 1773-1780
        • Eakin M.N.
        • Chung S.E.
        • Hoehn J.
        • Borrelli B.
        • Rand-Giovannetti D.
        • Riekert K.A.
        Development and validation of cf-medication beliefs questionnaire: A mixed-methods approach.
        Journal of Cystic Fibrosis. 2017; 16: 637-644
        • Eassey D.
        • Reddel H.K.
        • Ryan K.
        • Smith L.
        ‘It is like learning how to live all over again’ A systematic review of people's experiences of living with a chronic illness from a self-determination theory perspective.
        Health Psychology and Behavioral Medicine. 2020; 8: 270-291
        • Edward K.
        • Cook M.
        • Stephenson J.
        • Giandinoto J.A.
        The impact of brief lifestyle self-management education for the control of seizures.
        British Journal of Nursing. 2019; 28: 348-354
        • Ellis D.A.
        • Berio H.
        • Carcone A.I.
        • Naar-King S.
        Adolescent and parent motivation for change affects psychotherapy outcomes among youth with poorly controlled diabetes.
        Journal of Pediatric Psychology. 2012; 37: 75-84
        • Cloutier M.M.
        • Baptist A.P.
        • Blake K.V.
        • Brooks E.G.
        • Walsh C.G.
        2020 focused updates to the asthma management guidelines: A report from the national asthma education and prevention program coordinating committee expert panel working group.
        Journal of Allergy and Clinical Immunology. 2020; 146 (Expert Panel Working Group of the National Heart, Lung, and Blood Institute (NHLBI) administered and coordinated National Asthma Education and Prevention Program Coordinating Committee (NAEPPCC),. . .): 1217-1270
        • Ferriz R.
        • González-Cutre D.
        • Sicilia Á.
        • Hagger M.S.
        Predicting healthy and unhealthy behaviors through physical education: A self-determination theory-based longitudinal approach.
        Scandinavian Journal of Medicine and Science in Sports. 2016; 26: 579-592
        • Flores G.
        • Snowden-Bridon C.
        • Torres S.
        • Perez R.
        • Walter T.
        • Brotanek J.
        • Tomany-Korman S.
        Urban minority children with asthma: Substantial morbidity, compromised quality and access to specialists, and the importance of poverty and specialty care.
        Journal of Asthma. 2009; 46: 392-398
        • Frey S.M.
        • Jones M.R.
        • Goldstein N.
        • Riekert K.
        • Fagnano M.
        • Halterman J.S.
        Knowledge of inhaled therapy and responsibility for asthma management among young teens with uncontrolled persistent asthma.
        Academic Pediatrics. 2018; 18: 317-323
        • Friederichs S.A.H.
        • Oenema A.
        • Bolman C.
        • Lechner L.
        Motivational interviewing and self-determination theory in a web-based computer tailored physical activity intervention: A randomized controlled trial.
        Psychology and Health. 2016; 31: 907-930
        • Gabe J.
        • Bury M.
        • Ramsay R.
        Living with asthma: The experiences of young people at home and at school.
        Social Science and Medicine. 2002; 55: 1619-1633
        • Gibson-Scipio W.
        • Gourdin D.
        • Krouse H.J.
        Asthma self-management goals, beliefs and behaviors of urban African American adolescents prior to transitioning to adult health care.
        Journal of Pediatric Nursing. 2015; 30: e53-e61
        • Gillison F.
        • Standage M.
        • Skevington S.
        Relationships among adolescents’ weight perceptions, exercise goals, exercise motivation, quality of life and leisure-time exercise behaviour: A self-determination theory approach.
        Health Education Research. 2006; 21: 836-847
        • Gillison F.
        • Standage M.
        • Skevington S.
        Changes in quality of life and psychological need satisfaction following the transition to secondary school.
        British Journal of Educational Psychology. 2008; 78: 149-162
        • Halterman J.S.
        • Riekert K.A.
        • Fagnano M.
        • Tremblay P.J.
        • Blaakman S.W.
        • Borrelli B.
        Effect of the School-Based Asthma Care for Teens (SB-ACT) program on asthma morbidity: A 3-arm randomized controlled trial.
        Journal of Asthma. 2022; 59: 494-506
        • Halterman J.S.
        • Riekert K.
        • Bayer A.
        • Fagnano M.
        • Tremblay P.
        • Blaakman S.
        • Borrelli B.
        A pilot study to enhance preventive asthma care among urban adolescents with asthma.
        Journal of Asthma. 2011; 48: 523-530
        • Hamrin V.
        • Sinclair V.G.
        • Gardner V.
        Theoretical approaches to enhancing motivation for adherence to antidepressant medications.
        Archives of Psychiatric Nursing. 2017; 31: 223-230
        • Hennessy-Harstad E.B.
        Empowering adolescents with asthma to take control through adaptation.
        Journal of Pediatric Health Care. 1999; 13: 273-277
        • Jones M.R.
        • Frey S.M.
        • Riekert K.
        • Fagnano M.
        • Halterman J.S.
        Transition readiness for talking with providers in urban youth with asthma: Associations with medication management.
        Journal of Adolescent Health. 2019; 64: 265-271
        • Juul L.
        • Rowlands G.
        • Maindal H.T.
        Relationships between health literacy, motivation and diet and physical activity in people with type 2 diabetes participating in peer-led support groups.
        Primary Care Diabetes. 2018; 12: 331-337
        • McGrady M.E.
        • Hommel K.A.
        Medication adherence and health care utilization in pediatric chronic illness: A systematic review.
        Pediatrics. 2013; 132: 730-740
        • McQuaid E.L.
        • Kopel S.J.
        • Klein R.B.
        • Fritz G.K.
        Medication adherence in pediatric asthma: Reasoning, responsibility, and behavior.
        Journal of Pediatric Psychology. 2003; 28: 323-333
        • Milligan K.L.
        • Matsui E.
        • Sharma H.
        Asthma in urban children: Epidemiology, environmental risk factors, and the public health domain.
        Current Allergy and Asthma Reports. 2016; 16: 33
        • Mitchell A.J.
        Adherence behaviour with psychotropic medication is a form of self-medication.
        Medical Hypotheses. 2007; 68: 12-21
        • Moorman J.E.
        • Zahran H.
        • Truman B.I.
        • Molla M.T.
        Current asthma prevalence – United States, 2006–2008.
        MMWR Supplements. 2011; 60: 84-86
        • National Asthma Education and Prevention Program
        Expert panel report 3 (EPR-3): Guidelines for the diagnosis and management of asthma-summary report 2007.
        Journal of Allergy and Clinical Immunology. 2007; 120: S94-S138
        • Ng J.Y.Y.
        • Ntoumanis N.
        • Thøgersen-Ntoumani C.
        • Deci E.L.
        • Ryan R.M.
        • Duda J.L.
        • Williams G.C.
        Self-determination theory applied to health contexts: A meta-analysis.
        Perspectives on Psychological Science. 2012; 7: 325-340
        • Niemiec C.P.
        • Ryan R.M.
        Autonomy, competence, and relatedness in the classroom: Applying self-determination theory to educational practice.
        Theory and Research in Education. 2009; 7: 133-144
        • Norcross J.C.
        • Krebs P.M.
        • Prochaska J.O.
        Stages of change.
        Journal of Clinical Psychology. 2011; 67: 143-154
        • Ntoumanis N.
        • Ng J.Y.Y.
        • Prestwich A.
        • Quested E.
        • Hancox J.E.
        • Thøgersen-Ntoumani C.
        • Williams G.C.
        A meta-analysis of self-determination theory-informed intervention studies in the health domain: Effects on motivation, health behavior, physical, and psychological health.
        Health Psychology Review. 2021; 15: 214-244
        • Oraka E.
        • Iqbal S.
        • Flanders W.D.
        • Brinker K.
        • Garbe P.
        Racial and ethnic disparities in current asthma and emergency department visits: Findings from the national health interview survey, 2001–2010.
        Journal of Asthma. 2013; 50: 488-496
        • Orrell-Valente J.K.
        • Jarlsberg L.G.
        • Hill L.G.
        • Cabana M.D.
        At what age do children start taking daily asthma medicines on their own?.
        Pediatrics. 2008; 122: e1186-e1192
        • Pradel F.G.
        • Hartzema A.G.
        • Bush P.J.
        Asthma self-management: The perspective of children.
        Patient Education and Counseling. 2001; 45: 199-209
        • Radloff L.S.
        The CES-D scale: A self-report depression scale for research in the general population.
        Applied Psychological Measurement. 1977; 1: 385-401
        • Riekert K.A.
        • Borrelli B.
        • Bilderback A.
        • Rand C.S.
        The development of a motivational interviewing intervention to promote medication adherence among inner-city, African-American adolescents with asthma.
        Patient Education and Counseling. 2011; 82: 117-122
        • Riggenbach A.
        • Goubert L.
        • Van Petegem S.
        • Amouroux R.
        Topical review: Basic psychological needs in adolescents with chronic pain—A self-determination perspective.
        Pain Research and Management. 2019; 20198629581
        • Ryan R.M.
        • Deci E.L.
        Overview of self-determination theory: An organismic-dialectical perspective.
        in: Deci E.L. Ryan R.M. Handbook of self-determination research. University of Rochester Press, Rochester, NY2002: 3-33
        • Ryan R.M.
        • Deci E.L.
        Intrinsic and extrinsic motivation from a self-determination theory perspective: Definitions, theory, practices, and future directions.
        Contemporary Educational Psychology. 2020; 61101860
        • Shankar M.
        • Fagnano M.
        • Blaakman S.W.
        • Rhee H.
        • Halterman J.S.
        Depressive symptoms among urban adolescents with asthma: A focus for providers.
        Academic Pediatrics. 2019; 19: 608-614
        • Vansteenkiste M.
        • Williams G.C.
        • Resnicow K.
        Toward systematic integration between self-determination theory and motivational interviewing as examples of top-down and bottom-up intervention development: Autonomy or volition as a fundamental theoretical principle.
        International Journal of Behavioral Nutrition and Physical Activity. 2012; 9: 23
        • Vaughn L.A.
        Foundational tests of the need-support model: A framework for bridging regulatory focus theory and self-determination theory.
        Personality and Social Psychology Bulletin. 2017; 43: 313-328
        • Williams G.C.
        • McGregor H.A.
        • Sharp D.
        • Levesque C.
        • Kouides R.W.
        • Ryan R.M.
        • Deci E.L.
        Testing a self-determination theory intervention for motivating tobacco cessation: Supporting autonomy and competence in a clinical trial.
        Health Psychology. 2006; 25: 91-101
        • Williams G.C.
        • Patrick H.
        • Niemiec C.P.
        • Williams L.K.
        • Divine G.
        • Lafata J.E.
        • Pladevall M.
        Reducing the health risks of diabetes: How self-determination theory may help improve medication adherence and quality of life.
        Diabetes Educator. 2009; 35: 484-492
        • Williams G.C.
        • Rodin G.C.
        • Ryan R.M.
        • Grolnick W.S.
        • Deci E.L.
        Autonomous regulation and long-term medication adherence in adult outpatients.
        Health Psychology. 1998; 17: 269-276