Division of General & Community Pediatrics, Cincinnati Children's Hospital Medical Center (AE Berset and WB Brinkman), Cincinnati, Ohio; Ms Berset is now with the Department of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Department of Pediatrics, University of Cincinnati College of Medicine (JN Epstein, KA Hommel, and WB Brinkman), Cincinnati, Ohio; Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center (JN Epstein and KA Hommel), Cincinnati, Ohio.
Acad Pediatr. 2023 May-Jun;23(4):762-772. doi: 10.1016/j.acap.2022.09.021. Epub 2022 Oct 4.
To quantitatively validate the preintention factors, behavioral intentions, and implementation factors and examine the relationships theorized by the Unified Theory of Behavior Change (UTBC) model among adolescents with attention-deficit/hyperactivity disorder (ADHD).
We conducted longitudinal analyses of data from 40 adolescents with ADHD, aged 11 to 15 years old, and their parents, including self-report of UTBC constructs using standardized measures. We collected pharmacy dispensing records for adolescents for the 4 months that followed. We used bivariate correlations to examine relationships between medication continuity, behavioral intentions, preintention factors, and the implementation factors. We conducted paired sample t-tests to compare adolescent and parent responses on UTBC items.
Adolescents (mean [standard deviation {SD}] age = 13.3 [1.2] years, 75% male, 77.5% non-Hispanic Black, 90% publicly insured) reported a mean total ADHD symptom score = 29.8/54 (SD = 10.94) and mean total impairment score = 18.7/52 (SD = 10.90) and had a mean percentage of days covered with medicine over 4 months = 0.21 (range = 0-0.97). Adolescent intention to take ADHD medicine every school day was significantly related to adolescents' subsequent medication continuity (r = 0.37, P < .05). Adolescent self-concept/image and confidence taking ADHD medicine were the most important factors related to the intention to take ADHD medicine every school day. Adolescents reported less belief and intention to take ADHD medicine and more barriers to taking ADHD medicine compared to their parents.
The UTBC model shed light on factors related to subsequent medication use, providing a plausible mechanism for additional research to intervene to promote future medication continuity.
定量验证预意图因素、行为意图和实施因素，并检验注意力缺陷/多动障碍（ADHD）青少年的统一行为变化理论（UTBC）模型中理论假设的关系。
我们对 40 名年龄在 11 至 15 岁的 ADHD 青少年及其父母进行了纵向数据分析，包括使用标准化量表对 UTBC 结构进行自我报告。我们收集了青少年在接下来的 4 个月内的药物配药记录。我们使用双变量相关性来检验药物连续性、行为意图、预意图因素和实施因素之间的关系。我们进行配对样本 t 检验来比较青少年和家长对 UTBC 项目的反应。
青少年（平均[标准差]年龄为 13.3[1.2]岁，75%为男性，77.5%为非西班牙裔黑人，90%为公共保险）报告的平均 ADHD 症状总分为 29.8/54（SD=10.94），总损伤评分为 18.7/52（SD=10.90），4 个月内药物覆盖率的平均百分比为 0.21（范围为 0-0.97）。青少年每天在学校服用 ADHD 药物的意图与他们随后的药物连续性显著相关（r=0.37，P<.05）。青少年自我概念/形象和服用 ADHD 药物的信心是与每天在学校服用 ADHD 药物的意图最相关的因素。与父母相比，青少年报告的对 ADHD 药物的信念和意图较少，对 ADHD 药物的障碍较多。
UTBC 模型揭示了与随后药物使用相关的因素，为进一步研究提供了一个合理的机制，以促进未来的药物连续性。
