Application of Theories of Change in Managing Children with Chronic Health Problems in Pediatric Care and Practice
To identify evidence-based behavioral interventions that can be used in pediatric practice to improve self-management by CSHCN and their families.
This project extensively reviewed medical and social science literature published between 2000-2013 to explore the theoretical underpinnings for pediatric behavior change and to offer recommendations to pediatrics as to how they can better support patients and families as they manage chronic illness. Few high-quality studies were identified that supported theory-based interventions for chronic disease management, though many referenced theoretical constructs through the use of terms such as “self-efficacy”, “health motivation,” and “behavior intention.” Social cognitive theory was the most frequently cited theory. Self-regulation Theory, Transtheoretical Model and Health Belief Model were also cited, though less often The review identified very few methodologically rigorous trials that conscientiously applied a theory or model. Those few studies that did test interventions rigorously tended to reach significant outcomes more frequently than did other studies that were simply theory-informed. The study suggests that future research to improve health behaviors and self-management use established theories of change, and purposely build on previous theory-based studies. The investigators plan to use the findings from this study to guide development of mobile gaming applications aimed to foster behavior change and improve adherence in children.