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Journal of Pediatric Psychology Advance Access published online on August 26, 2009
Journal of Pediatric Psychology, doi:10.1093/jpepsy/jsp072
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© The Author 2009. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

The Efficacy of Adherence Interventions for Chronically Ill Children: A Meta-Analytic Review

Montserrat M Graves, PhD1, Michael C. Roberts, PhD ABPP1, Michael Rapoff, PhD2 and Amanda Boyer, MA3

1University of Kansas, 2University of Kansas Medical Center and 3University of Missouri-Kansas City

All correspondence concerning this article should be addressed to Montserrat M. Graves, PhD, Psychological Center for Growth and Development, 200 Gordon Avenue, Thomasville, GA 31792, USA. E-mail: dr.montserrat.graves{at}gmail.com


  Abstract

Objectives To provide quantitative information about the overall effectiveness of adherence interventions to improve adherence and health outcomes for children with chronic illnesses. To evaluate statistically the potential moderators. Methods A meta-analysis was performed on 71 adherence intervention studies. Results Weighted-mean effect size (ES) across all the adherence outcomes for group design studies was in the medium range (mean d = 0.58) and for single-subject design studies was in the large range (mean d = 1.44). The weighted mean ES across all health outcome measures for studies using group designs was in the medium range (mean d = 0.40) and for studies using single-subject designs was in the large range (mean d = 0.74). Conclusions Adherence interventions for children with chronic illnesses effectively increase adherence and result in some positive health benefits. Intervention and methodological variables had significant impact on ESs. High levels of heterogeneity characterized the data.

Key words: adherence; chronic illness; meta-analysis..

Received November 12, 2008; revision received July 16, 2009; accepted July 18, 2009


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