Self-reports are a primary source of behavioral data. This research group has conducted previous research showing that many patients over-report treatment adherence, that self-reports are unreliable whether provided by face-to-face interview or by clinical trial diary card and that parents are even less reliable sources of adherence information than children. Computer-assisted interviewing has repeatedly revealed more information than face-to-face interviewing or paper-and-pencil questionnaires about high risk sexual and drug-use behaviors, but has not before been applied to adherence assessment in chronic pediatric conditions. The primary objective of this proposed study is to examine the influence of mode of data collection on the validity of self-reports of inhaled anti-inflammatory medication adherence, as compared with an objective criterion obtained via electronic monitoring. We hypothesize that self-reports of medication adherence will have the lowest concordance with objective measures under conditions of highest assessment personalization (i.e. face-to-face interview) and highest concordance under conditions of lowest assessment personalization (i.e. telephone computer-assisted interview). Further, children are expected to be more accurate reporters than their parents, but that parent child-discrepancy will decrease with increasing child age. Pediatric asthma patients (N=120) will be enrolled in a six-month asthma education study and will be randomized to: 1) clinic-based interviewer administered questionnaire, 2) clinic-based computer-assisted data collection, or 3) home-based computer-assisted telephone interview. Parent reports and child reports will be collected separately. Objective, electronically recorded adherence data will be compared with self-reports. We will also examine how interview mode influences self-reports of other outcome measures including asthma symptoms and quality of life. Results of this study, together with those from our collaborative Interactive Research Project Grant (IRPG) institution (Johns Hopkins), will demonstrate how data collection methods influence self-report and serve to identify optimal self-report strategies in clinical research settings. Results from this investigation are expected to have immediate and direct implication for clinical research in asthma and with other chronic conditions.

R01HL064199

2001-02-10

2007-01-31