title: A validated measure of adherence to antibiotic prophylaxis in children with sickle cell disease.
abstract: BACKGROUND
  Antibiotic prophylaxis is a mainstay in sickle cell disease management. However, adherence is estimated at only 66%. This study aimed to develop and validate a Sickle Cell Antibiotic Adherence Level Evaluation (SCAALE) to promote systematic and detailed adherence evaluation.
  
  
  METHODS
  A 28-item questionnaire was created, covering seven adherence areas. General Adherence Ratings from the parent and one health care provider and medication possession ratios were obtained as validation measures.
  
  
  RESULTS
  Internal consistency was very good to excellent for the total SCAALE (α=0.89) and four of the seven subscales. Correlations between SCAALE scores and validation measures were strong for the total SCAALE and five of the seven subscales.
  
  
  CONCLUSIONS
  The SCAALE provides a detailed, quantitative, multidimensional, and global measurement of adherence and can promote clinical care and research.
authors.affiliation: Department of Hematology, Indiana Hemophilia and Thrombosis Center, Indianapolis, IN, USA.
authors.forename: Natalie A
authors.initials: NA
authors.lastname: Duncan
authors.affiliation: Department of Psychiatry, Indiana University School of Medicine Riley and Child Adolescent Psychiatry Clinic, Indianapolis, IN, USA.
authors.forename: William G
authors.initials: WG
authors.lastname: Kronenberger
authors.affiliation: Department of Hematology, Indiana Hemophilia and Thrombosis Center, Indianapolis, IN, USA.
authors.forename: Kisha C
authors.initials: KC
authors.lastname: Hampton
authors.affiliation: Department of Hematology, Indiana Hemophilia and Thrombosis Center, Indianapolis, IN, USA.
authors.forename: Ellen M
authors.initials: EM
authors.lastname: Bloom
authors.affiliation: Department of Hematology, Indiana Hemophilia and Thrombosis Center, Indianapolis, IN, USA.
authors.forename: Angeli G
authors.initials: AG
authors.lastname: Rampersad
authors.affiliation: Department of Hematology, Indiana Hemophilia and Thrombosis Center, Indianapolis, IN, USA.
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Roberson
authors.affiliation: Department of Hematology, Indiana Hemophilia and Thrombosis Center, Indianapolis, IN, USA.
authors.forename: Amy D
authors.initials: AD
authors.lastname: Shapiro
keywords: SCAALE; Sickle SAFE Program; compliance; hemoglobinopathy; newborn screening program; penicillin prophylaxis