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Examining the Unified Theory of Behavior Change Constructs Among Adolescents Taking Attention-Deficit/Hyperactivity Disorder Medicine: A Longitudinal Study

  • Anne E. Berset
    Correspondence
    Address correspondence to Anne E. Berset, BA, Division of General & Community Pediatrics, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229
    Affiliations
    Division of General & Community Pediatrics, Cincinnati Children's Hospital Medical Center (AE Berset and WB Brinkman), Cincinnati, Ohio

    Ms Berset is now with the Department of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
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  • Jeffery N. Epstein
    Affiliations
    Department of Pediatrics, University of Cincinnati College of Medicine (JN Epstein, KA Hommel, and WB Brinkman), Cincinnati, Ohio

    Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center (JN Epstein and KA Hommel), Cincinnati, Ohio
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  • Kevin A. Hommel
    Affiliations
    Department of Pediatrics, University of Cincinnati College of Medicine (JN Epstein, KA Hommel, and WB Brinkman), Cincinnati, Ohio

    Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center (JN Epstein and KA Hommel), Cincinnati, Ohio
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  • William B. Brinkman
    Affiliations
    Division of General & Community Pediatrics, Cincinnati Children's Hospital Medical Center (AE Berset and WB Brinkman), Cincinnati, Ohio

    Department of Pediatrics, University of Cincinnati College of Medicine (JN Epstein, KA Hommel, and WB Brinkman), Cincinnati, Ohio
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Published:October 03, 2022DOI:https://doi.org/10.1016/j.acap.2022.09.021

      Abstract

      Objective

      To quantitatively validate the preintention factors, behavioral intentions, and implementation factors and examine the relationships theorized by the Unified Theory of Behavior Change (UTBC) model among adolescents with attention-deficit/hyperactivity disorder (ADHD).

      Methods

      We conducted longitudinal analyses of data from 40 adolescents with ADHD, aged 11 to 15 years old, and their parents, including self-report of UTBC constructs using standardized measures. We collected pharmacy dispensing records for adolescents for the 4 months that followed. We used bivariate correlations to examine relationships between medication continuity, behavioral intentions, preintention factors, and the implementation factors. We conducted paired sample t-tests to compare adolescent and parent responses on UTBC items.

      Results

      Adolescents (mean [standard deviation {SD}] age = 13.3 [1.2] years, 75% male, 77.5% non-Hispanic Black, 90% publicly insured) reported a mean total ADHD symptom score = 29.8/54 (SD = 10.94) and mean total impairment score = 18.7/52 (SD = 10.90) and had a mean percentage of days covered with medicine over 4 months = 0.21 (range = 0–0.97). Adolescent intention to take ADHD medicine every school day was significantly related to adolescents’ subsequent medication continuity (r = 0.37, P < .05). Adolescent self-concept/image and confidence taking ADHD medicine were the most important factors related to the intention to take ADHD medicine every school day. Adolescents reported less belief and intention to take ADHD medicine and more barriers to taking ADHD medicine compared to their parents.

      Conclusion

      The UTBC model shed light on factors related to subsequent medication use, providing a plausible mechanism for additional research to intervene to promote future medication continuity.

      Keywords

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