Norman A. Krasnegor
This section explores the topic of intervention approaches designed to improve compliance in children who are afflicted with chronic disease. Three chapters are offered. Two of the three focus on a particular disease (asthma and diabetes) and use the research reviewed to elucidate the unique compliance problems raised by the disease for the affected children. The third chapter employs a health compliance research example, associated with medicine taking to reduce cholesterol level in an adult population. Important conclusions can be drawn from each of the chapters concerning general principles that can guide strategies for intervening with health compliance behaviors over a developmental range that covers childhood through adolescence.
The first chapter in this section, "Adherence Intervention Research: The Need for a Multilevel Approach" by W. Stewart Agras, has as its focus an overview of the factors that must be addressed when approaching research on interventions for influencing adherence to health regimens. Agras first probes the question of who should be studied. He points to the fact that not only the patient but, depending on his or her developmental stage, the family, school/worksite, community, and national economy might have to be taken into consideration. The other elements that must be included are the health care professionals and the patient's contact with the health care system, and the finding of only weak relationships between level of adherence and clinical outcome.