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Arch Pediatr Adolesc Med. 2002 Jun;156(6):533-9.

A randomized, controlled trial of a community-based support program for families of children with chronic illness: pediatric outcomes.

Author information

1
Department of Pediatrics, School of Medicine, John Hopkins University, 600 N Broadway, Baltimore, MD 21287, USA. rchernof@jhmi.edu

Abstract

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.

PMID:
12038883
[Indexed for MEDLINE]

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