 |
|
A Randomized, Controlled Trial of a Community-Based Support Program for Families of Children With Chronic Illness: Pediatric Outcomes
Robin G. Chernoff, MD;
Henry T. Ireys, PhD;
Katherin A. DeVet, PhD;
Young J. Kim, PhD
Arch Pediatr Adolesc Med. 2002;156:533-539.
Background Children with chronic illnesses have a heightened risk for mental health
problems.
Objectives To develop, implement, and evaluate child outcomes of a 15-month, community-based,
family-support intervention designed to reduce risk for poor adjustment and
mental health problems in children with 1 of 4 chronic illnesses (diabetes
mellitus, sickle cell anemia, cystic fibrosis, or moderate to severe asthma)
and their mothers.
Design Randomized, controlled clinical trial design with multiple measures
of mental health based on both child and parent reports taken 1 year apart.
Setting Community-based intervention linked to subspecialty and general pediatric
clinics and practices in Baltimore, Md.
Participants One hundred thirty-six mothers and children aged 7 to 11 years with
diabetes mellitus, sickle cell anemia, cystic fibrosis, or moderate to severe
asthma.
Intervention The program, provided by "experienced mothers" and child life specialists,
included telephone contacts, face-to-face visits, and special family events.
Main Outcome Measures Outcomes were measured using the following instruments: the Personal
Adjustment and Role Skills Scale III, the Children's Depression Inventory,
the Revised Children's Manifest Anxiety Scale, and the Self-Perception Profile
for Children.
Results The experimental group's mean adjustment score increased over the intervention
period while the control group's mean adjustment score decreased. Analysis
of variance demonstrated that the intervention had a significant main effect
on postintervention adjustment controlling for baseline scores (P = .01). Using a cutoff score indicating maladjustment, the percentage
of experimental group children in the maladjustment range fell from 19% at
baseline to 10% after the intervention; the percentage of control group children
in the maladjustment range rose from 15% at baseline to 21% after the intervention.
The effect of the intervention was more pronounced for children who had low
physical self-esteem than for those who had moderate to high physical self-esteem
at the beginning of the program.
Conclusions Our results demonstrate modest positive effects of a family support
intervention in promoting the adjustment of children with selective chronic
health conditions. Including child life specialists in a community-based intervention
may be especially salient for children with chronic illnesses who have low
physical self-esteem. The intervention had a similar outcome for all diagnostic
groups, suggesting that it could be effective for children with any chronic
illness and implemented in a variety of pediatric settings.
From the Department of Pediatrics, School of Medicine (Dr Chernoff),
Mathematica Policy Research, Inc (Dr Ireys), and the Department of Population
and Family Health Sciences, Bloomberg School of Public Health (Drs DeVet and
Kim), Johns Hopkins University, Baltimore, Md.
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Parent Quality of Life in the Context of Pediatric Inflammatory Bowel Disease
Greenley and Cunningham
J Pediatr Psychol 2008;0:jsn056v1-jsn056.
ABSTRACT
| FULL TEXT
The Potential for Reducing Asthma Disparities Through Improved Family and Social Function and Modified Health Behaviors
Mangan et al.
Chest 2007;132:789S-801S.
ABSTRACT
| FULL TEXT
A Family-Centered, Community-Based System of Services for Children and Youth With Special Health Care Needs
Perrin et al.
Arch Pediatr Adolesc Med 2007;161:933-936.
ABSTRACT
| FULL TEXT
Who joins support groups among parents of children with autism?
Mandell and Salzer
Autism 2007;11:111-122.
ABSTRACT
Prevalence and Correlates of Early Onset Asthma and Wheezing in a Healthy Birth Cohort of 2- to 3-Year Olds
Berz et al.
J Pediatr Psychol 2007;32:154-166.
ABSTRACT
| FULL TEXT
Children at Risk for Special Health Care Needs
Newacheck et al.
Pediatrics 2006;118:334-342.
ABSTRACT
| FULL TEXT
Context Matters: A Community-Based Study of Maternal Mental Health, Life Stressors, Social Support, and Children's Asthma
Shalowitz et al.
Pediatrics 2006;117:e940-e948.
ABSTRACT
| FULL TEXT
Comprehensive Primary Care for Children With Special Health Care Needs in Rural Areas
Farmer et al.
Pediatrics 2005;116:649-656.
ABSTRACT
| FULL TEXT
Family Influences on Pediatric Asthma
Kaugars et al.
J Pediatr Psychol 2004;29:475-491.
ABSTRACT
| FULL TEXT
Prevalence and Characteristics of Children With Special Health Care Needs
van Dyck et al.
Arch Pediatr Adolesc Med 2004;158:884-890.
ABSTRACT
| FULL TEXT
How Do I Judge the "Medical Homeness" of My Practice?
Schulz et al.
CLIN PEDIATR 2004;43:431-435.
ABSTRACT
OTHER ARTICLES NOTED (Nov 01 to 18 Oct 02)
Evid. Based Nurs. 2003;6:e1-1.
FULL TEXT
|
