338 - Motivation and Perceived Competence Among Adolescents Prescribed Preventive Asthma Medication: Opportunities to Support Self-Management

Publication Number: 2327.338

Michael H. Chen, Golisano Children's Hospital at The University of Rochester Medical Center, Pittsford, NY, United States; Maria Fagnano, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States; Susan W.. Blaakman, University of Rochester School of Nursing, ROCHESTER, NY, United States; Jill Halterman, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States

Background: Adolescence is a developmental stage marked by increasing independence and transition to self-managed health care. For teens with asthma, this often coincides with declining adherence to preventive medication. Guided by Self-Determination Theory (SDT), understanding how motivation and perceived competence relate to self-management behaviors may identify targets to support sustained adherence and improved asthma control.

Objective: To examine associations between motivational constructs and self-management behaviors among adolescents prescribed preventive asthma medication.

Design/Methods: Baseline data were drawn from the ongoing Telemedicine Enhanced Asthma Management-Uniting Providers for Teens (TUFT) study. Adolescents (11-17 years) with persistent or poorly controlled asthma and preventive medication prescription completed the Treatment Self-Regulation Questionnaire (TSRQ) and the Perceived Competence Scale (PCS) for asthma management (N=102; participation rate 60%). Bivariate and multivariable analyses examined associations between motivation constructs and self-management indicators, including daily adherence, recent preventive medication use, missed doses, action-plan ownership, and carrying asthma medication when away from home.

Results: Among teen participants (mean age 13.6 years; 55% Black, 38% Hispanic, 69% publicly insured), we found that higher autonomous motivation was associated with having an asthma action plan (p=.02) and carrying medication away from home (p=.04). Higher amotivation was associated with missing ≥ 1 preventive medication doses (p=.03). Controlled motivation and perceived competence were not associated with any self-management behavior. In multivariate models, autonomous motivation remained associated with carrying asthma medications when away from home (OR 2.12, 95%CI 1.12-4.02). Younger age and identifying as Black or Hispanic were associated with higher odds of having an asthma action plan (p <.05), while more symptom-free days was associated with lower odds of daily medication adherence (p=.02).

Conclusion(s): Adolescents in this sample reported relatively high autonomous motivation and perceived competence with some associations between motivation and asthma self-management behaviors. The association of amotivation with missed doses suggests a potential psychological barrier to medication adherence. Interventions that pair autonomy-supportive communication with practical, system-level supports may better bridge this gap and promote sustained self-management.

Table 1. Sample Participant Characteristics, Clinical Profile, and Key Study Variables (N = 102)
Characteristics are presented as Mean ± SD or n (%)

Table 2. Bivariate Associations Between Motivation, Perceived Competence, and Self-Management Behaviors
Bivariate analyses (t-tests) are shown. t(p). *p < .05

Table 3. Multivariate Models Exploring Associations Between Motivation, Perceived Competence, and Self-Management Behaviors Among Adolescents Prescribed Preventive Medication
Multivariate Logistic Regression models are shown for each outcome. OR (95% CI). *p < .05; †p < .10.