INTERVENTION STRATEGIES TO IMPROVE MATERNAL ADHERENCE

一系列研究将允许评估干预措施 旨在加强产妇坚持医疗保健的战略 对儿童健康问题提出了建议。 的 干预策略将针对母亲，儿科医生， 儿科医疗团队的其他成员。 每项研究 将通过采用实验设计（即，与 实验组和对照组），并通过 客观和主观的措施相结合。 尽可能 干预措施将在涉及急性和 慢性疾病和涉及不同社会经济地位的母亲。 这些战略将包括以下技术： 执行以合规为导向的“教育诊断”;增加接触 提供者和母亲之间通过电话随访;提供 不同格式的信息（包括患者包测试 以及修改所述方案的结构特征。 一个 其中一项拟议研究的例子，儿科医生指导的教育 干预，详细介绍。 初级保健儿科医生和 儿科家庭工作人员将被随机分配到两个级别的任何一个， 儿科医生指导的教育（书面材料或书面 单独材料）或对照组。 干预后的访谈， 问卷将提供对以遵守为导向的知识的评估， 儿科医生的态度和行为。 对于每个儿科医生， 将随机选择患有中耳炎或哮喘的儿童。 一 干预后的访谈将提供对母亲 以遵守为导向的健康信念和满意度 儿科医生和母亲的互动。 遵约成果和儿童健康 将衡量成果。

A series of studies which will permit the assessment of intervention strategies designed to enhance maternal adherence to medical recommendations for children's health problems is proposed. The intervention strategies will be directed at mothers, at pediatricians, and at other members of the pediatric health care team. Each of the studies will be conducted by employing an experimental design (i.e., with experimental and control groups) and compliance will be determined by a combination of objective and subjective measures. Whenever possible interventions would be tested under conditions involving both acute and chronic conditions and involving mothers of varying socioeconomic status. The strategies would include such techniques as: teaching the provider to perform a compliance-oriented "educational diagnosis"; increasing contact between provider and mother through telephone follow-up; providing information in varying formats (including tests of Patient Package Inserts); and modifying structural characteristics of the regimen. An example of one of the proposed studies, a pediatrician-directed education intervention, is presented in detail. Primary care pediatricians and pediatric housestaff would be randomly assigned to either of two levels of pediatrician-directed education (Tutorial and Written Material or Written Material-Alone) or a control group. A post-intervention interview and questionnaire will provide assessments of compliance-oriented knowledge, attitudes and behaviors of pediatricians. For each pediatrician, a sample of children having otitis media or asthma will be randomly selected. A post-intervention interview will provide assessments of mothers' compliance-oriented health beliefs and satisfaction with the pediatrician-maternal interaction. Compliance outcomes and child health outcomes will be measured.