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Journal of Pediatric Psychology, Vol. 28, No. 6, 2003, pp. 383-392
© 2003 Society of Pediatric Psychology

The Illness Management Survey: Identifying Adolescents' Perceptions of Barriers to Adherence

Deirdre Logan, PHD, Nataliya Zelikovsky, PHD, Larissa Labay, PSYD and Jonathan Spergel, MD, PHD

The Children's Hospital of Philadelphia

All correspondence should be sent to Deirdre Logan, PhD, Department of Psychology, Children's Hospital of Philadelphia, 34th & Civic Center Blvd., Philadelphia, Pennsylvania 19104. E-mail: logan{at}email.chop.edu.

Objective To develop a self-report measure of barriers to adherence and to evaluate its reliability and validity in a sample of adolescents with asthma. Methods The Illness Management Survey (IMS) was developed through item generation, expert panel review, and focus group administration. Adolescents with asthma (N = 152) completed the measure. Participants reported on perceived drawbacks to medication, risk-taking behavior, and social desirability tendencies. Providers rated adolescents' illness severity and adherence. Reliability and validity of the IMS were assessed, and factor structure was examined. Results The 27-item IMS shows high internal consistency (alpha =.87). Scores correlate with perceived medication drawbacks, risk taking, and self- and provider reports of adherence. Principal-components analysis indicates five domains of barriers, accounting for 52.4% of the variance: disease/regimen issues, cognitive difficulties, lack of social support/lack of self-efficacy, denial/distrust, and peer/family issues. Conclusions Preliminary data indicate that the IMS reliably and validly assesses perceived barriers to adherence within this sample of adolescents with asthma. It shows promise as a tool for identifying subgroups of nonadherent adolescents.

Key words: regimen adherence; adolescence; psychological assessment; chronic illness.


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