The development of a motivational interviewing intervention to promote medication adherence among inner-city, African-American adolescents with asthma

ObjectiveTo develop and assess the feasibility of a motivational interviewing (MI) based asthma self-management program for inner-city, African-American, adolescents with asthma.Methods37 African-American adolescents (age 10–15 years) recently seen in an inner-city emergency department for asthma and prescribed an asthma controller medication participated in the newly developed program consisting of 5 home visits. Adolescents and their caregivers completed phone-based surveys before and after the intervention.Results95% of the adolescents completed all 5 sessions; 89% of caregivers and 76% of adolescents believed other families would benefit from the intervention. Caregivers were more likely to report 100% adherence post-intervention compared to pre-intervention and reported a trend for adolescents taking greater responsibility for their asthma. There were no pre-post-differences in adolescent-reported medication adherence, but adolescents did reported increased motivation and readiness to adhere to treatment. Caregivers and adolescents each reported statistically significant increases in their asthma quality of life.ConclusionsThe findings from this pilot study suggest that MI is a feasible and promising approach for increasing medication adherence among inner-city adolescents with asthma and is worthy of further evaluation in a randomized trial.Practice ImplicationsIncorporating MI into disease management programs may enhance their effectiveness.