TY - JOUR
T1 - Factors associated with attaining coaching goals during an intervention to improve child asthma care
AU - Nelson, Kyle A.
AU - Highstein, Gabriele
AU - Garbutt, Jane
AU - Trinkaus, Kathryn
AU - Smith, Sharon R.
AU - Strunk, Robert C.
N1 - Copyright:
Copyright 2013 Elsevier B.V., All rights reserved.
PY - 2012/9
Y1 - 2012/9
N2 - Purpose: To examine parent and child characteristics associated with engagement in a coaching intervention to improve pediatric asthma care and factors associated with readiness to adopt and maintain targeted asthma management behaviors. Methods: Using methods based on the Transtheoretical Model, trained lay coaches worked with 120 parents of children with asthma promoting adoption and maintenance of asthma management strategies (behaviors). Coaches assigned stage-of-change (on continuum: pre-contemplation, contemplation, preparation, action, maintenance) for each behavior every time it was discussed. Improvement in stage-of-change was analyzed for association with characteristics of the participants (parents and children) and coaching processes. Results: Having more coach contacts was associated with earlier first contact (p< 0.001), fewer attempts per successful contact (p< 0.001), prior asthma hospitalization (p= 0.021), more intruding events (p< 0.001), and less social support (p= 0.048). In univariable models, three factors were associated with forward movement at least one stage for all three behaviors: more coach contacts overall, fewer attempts per successful contact, and more discussion/staging episodes for the particular behavior. In multivariable models adjusting for characteristics of participants and coaching process, the strongest predictor of any forward stage movement for each behavior was having more contacts (p< 0.05). Conclusions: Improvement in readiness to adopt and maintain asthma management behaviors was mostly associated with factors reflecting more engagement of participants in the program. Similar coaching interventions should focus on early and frequent contacts to achieve intervention goals, recognizing that parents of children with less severe disease and who have more social support may be more difficult to engage.
AB - Purpose: To examine parent and child characteristics associated with engagement in a coaching intervention to improve pediatric asthma care and factors associated with readiness to adopt and maintain targeted asthma management behaviors. Methods: Using methods based on the Transtheoretical Model, trained lay coaches worked with 120 parents of children with asthma promoting adoption and maintenance of asthma management strategies (behaviors). Coaches assigned stage-of-change (on continuum: pre-contemplation, contemplation, preparation, action, maintenance) for each behavior every time it was discussed. Improvement in stage-of-change was analyzed for association with characteristics of the participants (parents and children) and coaching processes. Results: Having more coach contacts was associated with earlier first contact (p< 0.001), fewer attempts per successful contact (p< 0.001), prior asthma hospitalization (p= 0.021), more intruding events (p< 0.001), and less social support (p= 0.048). In univariable models, three factors were associated with forward movement at least one stage for all three behaviors: more coach contacts overall, fewer attempts per successful contact, and more discussion/staging episodes for the particular behavior. In multivariable models adjusting for characteristics of participants and coaching process, the strongest predictor of any forward stage movement for each behavior was having more contacts (p< 0.05). Conclusions: Improvement in readiness to adopt and maintain asthma management behaviors was mostly associated with factors reflecting more engagement of participants in the program. Similar coaching interventions should focus on early and frequent contacts to achieve intervention goals, recognizing that parents of children with less severe disease and who have more social support may be more difficult to engage.
KW - Asthma
KW - Child
KW - Coach
KW - Engagement
KW - Parent
KW - Stage-of-change
UR - http://www.scopus.com/inward/record.url?scp=84864303885&partnerID=8YFLogxK
U2 - 10.1016/j.cct.2012.05.012
DO - 10.1016/j.cct.2012.05.012
M3 - Article
C2 - 22664649
AN - SCOPUS:84864303885
VL - 33
SP - 912
EP - 919
JO - Contemporary Clinical Trials
JF - Contemporary Clinical Trials
SN - 1551-7144
IS - 5
ER -