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Randomized Controlled Trial
. 2010 Aug;47(6):667-73.
doi: 10.3109/02770900903518827.

Factors associated with nonresponse to a computer-tailored asthma management program for urban adolescents with asthma

C L M Joseph  1 , S L Havstad, D Johnson, J Saltzgaber, E L Peterson, K Resnicow, D R Ownby, A P Baptist, C C Johnson, V J Strecher
Affiliations
Randomized Controlled Trial

Factors associated with nonresponse to a computer-tailored asthma management program for urban adolescents with asthma

C L M Joseph et al. J Asthma. 2010 Aug.

Abstract

Background: The ability to identify potentially resistant participants early in the course of an intervention could inform development of strategies for behavior change and improve program effectiveness.

Objective: The objective of this analysis was to identify factors related to nonresponse (i.e., lack of behavior change) to an asthma management intervention for urban teenagers. The intervention targeted several behaviors, including medication adherence, having a rescue inhaler nearby, and smoking.

Methods: A discriminate analysis was conducted using data from a randomized trial of the intervention. Included in this analysis are participants who reported a physician diagnosis of asthma, completed a baseline questionnaire, were randomized to the treatment group, completed >or=2 of 4 educational sessions, and completed >or=2 of 3 follow-up questionnaires. Ninety students met criteria for inclusion in this subgroup analysis.

Results: In logistic regression models for medication adherence, nonresponse was related to low baseline asthma self-regulation, odds ratio = 3.6 (95% confidence interval = 1.3-9.5). In models for having an inhaler nearby, nonresponse was related to low baseline self-regulation and to rebelliousness, OR = 4.7 (1.6-13.2) and 5.6 (1.7-18.0), respectively. Nonresponse to smoking messages was related to rebelliousness, low emotional support, and low religiosity, ORs = 7.6 (1.8-32.3), 9.5 (1.4-63.5), and 6.6 (1.5-29.8) respectively.

Conclusions: Certain variables had the ability to discriminate the likelihood of response from that of nonresponse to an asthma program for urban, African American adolescents with asthma. These variables can be used to identify resistant subgroups early in the intervention, allowing the application of specialized strategies through tailoring. These types of analyses can inform behavioral interventions.

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Conflict of interest statement

Declaration of Interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Figures

Figure 1
Figure 1
Steps to increasing effectiveness of a web-based asthma management program for urban teenagers. Step 1 is the focus of this paper.
Figure 2
Figure 2
Sample used for analysis of characteristics associated with non-response to a computer-tailored asthma intervention for urban teens.
Figure 3
Figure 3
Receiver Operating Characteristic Curves (ROC) and Area Under the Curve (AUC) for variables associated with non-response in a computer-tailored asthma management program for urban teenagers. *Includes cannibis and cigars.
See this image and copyright information in PMC

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