Meta-analysis of psychological interventions to promote adherence to treatment in pediatric chronic health conditions.
OBJECTIVE
To estimate the effectiveness of adherence-promoting psychological interventions for pediatric populations with chronic health conditions.


METHODS
A meta-analysis was conducted on 70 adherence-promoting psychological intervention studies among chronically ill youth using a weighted least squares approach and random effect model.


RESULTS
Medium effects sizes were found for the behavioral (mean d =.54, 95% confidence interval [CI] = 0.34-0.73, n = 10) and multi-component interventions (mean d =.51, 95% CI = 0.45-0.57, n = 46), while educational interventions displayed a small effect size with adherence (mean d =.16, 95% CI = 0.10-0.22, n = 23). Study designs incorporating pre-post comparisons yielded effect sizes approaching the medium range (mean d =.42, 95% CI = 0.36-0.48, n = 30).


CONCLUSIONS
Behavioral and multi-component interventions appear to be relatively potent in promoting adherence among chronically ill youth. Recommendations for future research and methodological issues are presented.
Kahana
Shoshana
S
National Institute of Mental Health, Division of Developmental Translational Research, 6001 Executive Blvd, MSC 9617, Room 6190, Bethesda, MD 20892, USA. sykahana@gmail.com.
Drotar
Dennis
D
Frazier
Tom
T
D001521:Behavior Therapy / Q000379:methods*; D002648:Child; D002908:Chronic Disease; D006304:Health Status; D006801:Humans; D001523:Mental Disorders / Q000453:epidemiology* / Q000628:therapy*; D010349:Patient Compliance / Q000706:statistics & numerical data*