Higher Outcome Expectations Research Articles

Assessing the Impact of Online Science Education on Iranian Pre-Service Primary Teachers’ Attitudes and Self-Efficacy Beliefs

ABSTRACT This study aimed to investigate Iranian pre-service primary teachers’ self-efficacy and attitudes toward teaching science during the COVID-19 pandemic. Data were collected through surveys with 360 pre-service primary teachers who completed their Science Education courses through virtual learning platforms. Results showed that the participants had positive attitudes, high science teaching outcome expectancy, and teaching science efficacy. The study also revealed no significant differences in self-efficacy and attitudes toward teaching science based on gender and year of entering the university. However, there was a statistically significant difference in self-efficacy and attitudes based on the type of high school field. Graduates in the Humanities field have a lower average attitude and self-efficacy toward teaching science than participants in the Science field. Additionally, a highly significant positive correlation was observed between pre-service teachers’ attitudes and their self-efficacy toward science teaching, suggesting that assessing their attitudes toward science teaching can be a robust predictor of their self-efficacy. These findings underscore the importance of nurturing positive attitudes among pre-service teachers to enhance their confidence and effectiveness in teaching science.

First impressions matter: The influence of initial assessments on psychological treatment initiation and subsequent dropout

Objective This study investigated if patients’ experience of an initial assessment may be associated with outcome expectations, and with subsequent treatment attendance. Method The sample comprised n = 6051 patients with depression/anxiety disorders, nested within k = 148 assessing therapists. Multilevel modelling (MLM) was used to examine therapist effects on treatment initiation and subsequent dropout, adjusting for patient-level characteristics. We tested associations between early outcome expectancy measured at an initial assessment with attendance at a first therapy session, and with dropout after initiation. Variability in mean expectancy ratings in the caseloads of assessing therapists was examined using the intracluster correlation coefficient (ICC). Results Therapist effects partly explained the variance in treatment initiation and dropout. Pre-treatment outcome expectations significantly predicted treatment initiation but not dropout for the subgroup of patients who started treatment. Approximately 16% of variability in mean expectancy ratings was explained by therapist effects (ICC = 0.159) after controlling for patient-level covariates. Conclusions Patients assessed by some therapists are more likely to have higher outcome expectations, which influences their decision to initiate treatment thereafter. Once patients start therapy, early expectancy measured at assessment no longer influences their attendance, but the “first impression” from an initial assessment does influence their subsequent likelihood of dropout.

Social Cognitive Theory and Willingness to Perform Recommended Health Behavior: The Moderating Role of Misperceptions

More than 6 million people have died due to the COVID-19 pandemic. In order to slow down the spread of COVID-19, health authorities have created numerous guidelines. In the current study, we use survey data from the U.S. and social cognitive theory (SCT) to examine the associations among self-efficacy, outcome expectancies, and willingness to perform recommended COVID-19 related health behavior. Considering the misinformation-filled information ecology during the pandemic, we also examine the moderating role of misperceptions in these relationships. Our findings show that in general the SCT hypotheses hold for COVID-19 related behavior willingness. The interaction effects with COVID-19 misperceptions show that self-efficacy is not enough to understand people’s health behavior. Higher outcome expectancies are important and may be able to overcome even if people held high misperceptions. Our findings have direct implications for communication theory and for health organizations in the contemporary information ecology.

Perceptions, facilitators, and barriers regarding use of the injury prevention exercise programme Knee Control among players and coaches in youth floorball: a cross-sectional survey study

BackgroundYouth participation in team ball sports is associated with a risk of both acute and gradual onset injuries but today there are several efficacious injury prevention exercise programmes (IPEPs). However, there is limited research about how to implement those programmes and the perceived barriers and facilitators among end-users.ObjectiveTo investigate perceptions of the IPEP Knee Control and facilitators and barriers to programme use among coaches and youth floorball players, and explore factors associated with planned maintenance of Knee Control.MethodsThis cross-sectional study is a sub-analysis of data from the intervention group of a cluster randomised controlled trial. Perceptions about Knee Control and facilitators and barriers to programme use were evaluated with surveys pre-intervention and post-season. 246 youth floorball players aged 12–17 years, and 35 coaches that reported no use of IPEPs during the preceding year were included. Descriptive statistics and univariate and multivariate ordinal logistic regression models were undertaken with the dependent variables: coaches’ planned maintenance and players’ opinions of maintenance of Knee Control. Independent variables were perceptions, facilitators and barriers regarding use of Knee Control and other potential influencing factors.Results88% of the players believed that Knee Control can reduce injury risk. Common facilitators to Knee Control use among coaches were support, education and high player motivation, and common barriers were that injury prevention training was time-consuming, lack of space to execute the exercises and lack of player motivation. Players who planned to maintain use of Knee Control had higher outcome expectancies and belief in one’s ability to use Knee Control (action self-efficacy). Coaches who planned to maintain Knee Control had higher action self-efficacy and to a lesser extent considered that Knee Control takes too much time.ConclusionsSupport, education, and high player motivation are key facilitators, while lack of time and space for injury prevention training and boring exercises are key barriers for coaches and players to use Knee Control. High action self-efficacy among coaches and players seems to be a prerequisite for maintained use of IPEPs.

Understanding professional commitment change of novice CFL university teachers: an integrated perspective

ABSTRACT This study examined three novice Chinese as a foreign language (CFL) university teachers’ professional commitment change in New Zealand from an integrated theoretical framework of professional commitment. Drawing on data from interviews, classroom observations, and teaching material, the study found that although all the participants had mixed reasons for becoming novice CFL university teachers abroad, their ensuing professional commitment towards CFL teaching either diminished, strengthened, or experienced no change under the joint effects of their self-efficacy, outcome expectations, professional autonomy, and social support. Specifically, the study showed that 1) either low or high teaching self-efficacy could be a hindrance to the sustainment of novice teachers’ professional commitment; 2) strong teaching self-efficacy together with high outcome expectations, to a large extent, could strengthen novice teachers’ professional commitment; and 3) professional autonomy and social support, to some extent, could modulate novice teachers’ teaching self-efficacy and thus bolster their professional commitment. This study concludes with practical implications for how to better support CFL university teachers’ continuous commitment to Chinese language teaching around the world.

The Disappointment Dilemma: The Role of Expectation Proclivity and Disappointment Aversion in Describing Financial Risk Aversion and Investing Risk-Taking Behavior

This article adds to the existing literature on financial risk aversion and risk taking by testing the possibility that a person’s degree of disappointment aversion, as an anticipatory emotion, may be an antecedent of risk-taking behavior. In this regard, the purpose of this article is to introduce two interrelated measures—the expectation-proclivity scale and the disappointment-aversion scale—and to establish the empirical association between expectation-proclivity and disappointment-aversion scale scores and financial risk aversion and financial risk taking. Results from this study show that disappointment aversion is positively associated with financial risk aversion, whereas establishing high outcome expectations is negatively related with financial risk aversion. Additionally, findings show that disappointment aversion and expectation proclivity are inversely related. Findings from this study provide support for what is termed in this article the disappointment dilemma hypothesis. Specifically, financial decision-makers who are averse to disappointment may be prone to allocating assets and investment dollars in ways that minimize or avoid disappointment in the short-run, but by doing so, may regret risk-avoiding behavior in the future.

PATHWAYS TO COMPUTER SCIENCE AT COMMUNITY COLLEGE: SINGLE MOTHERS AS RETURNING STUDENTS

Focusing on adult women (re-)entering college to study computer science is one avenue to broadening participation in computing, and community college computer science departments are primed to take advantage of this population of overlooked students. One understudied group is single mothers who are studying computer science with the intention of transfer and completion of a bachelor’s degree in preparation for entering a computing career. Social cognitive career theory describes the social cognitive process by which individuals gain interests and make career-based decisions, and we used this framework as a guide in a single case study to answer the research question: How does a returning single mother experience community college as a step on a pathway with a goal of a bachelor’s degree in computer science and entry into a computing job? To answer this question, we analyzed data from an interview and a follow-up message exchange with a 28-year-old white female single parent who was attending a community college in California at the time of the study. Findings from this study demonstrate that women returning to college to study computer science can experience high self-efficacy and outcome expectations. Implications from this work suggest that college departments could trumpet the salaries and availability of computing jobs to attract returning female students, emphasizing those careers that are pro-social. These students may be adopted as leaders, counted upon to ask questions that younger students are too afraid to verbalize and to run college organizations focused on computing majors and careers.

Impact of a journal club on the self-efficacy, expectations, and intentions of nursing students toward evidence-based results

Nursing associations require that nurses develop the skills to integrate evidence into practice to support the quality of care. Lack of self-confidence in the operational steps of evidence-based practice was identified as a barrier to integrating evidence into nursing practice. To assess the effect of a journal club (JC) on nursing students' self-efficacy (SE), expectations, and intentions to use evidence. Quasi-experimental, longitudinal approach with a non-randomized comparison group. The development of SE toward the use of evidence-based practices favored students who participated in the JC (n=48) compared to students who received a conventional educational modality (CEM) (n=50). However, there was no significant group x time interaction effect on expectations or intentions. The significant positive changes beyond the CEM may be explained by the fact that the JC incorporated modes of influence on SE. The positive effect associated with the JC on SE is difficult to sustain without continued practice. It is important to maintain high outcome expectations within nursing training.

When Media Health Stories Conflict: Test of the Contradictory Health Information Processing (CHIP) Model

Guided by Uncertainty Management Theory, UMT, we tested a model that explicates how uncertainty arising from contradictory health information is managed through information seeking. In an online experiment, 763 U.S. adults were randomly assigned to one of three message conditions: contradictory, non-contradictory, or control. Participants in the contradictory and non-contradictory conditions answered questions about their perceptions of contradiction, issue and decision uncertainty, negative appraisals and emotions, and information-seeking intentions. They also completed measures of several moderator variables, including information overload, intolerance for uncertainty, and health self-efficacy. Baseline levels of issue and decision uncertainty were measured in the control condition. Model tenets were confirmed: perceptions of contradiction led to issue uncertainty which, in turn, prompted cognitive appraisals directly, and indirectly through increased decision uncertainty. The effects of issue and decision uncertainty on information-seeking intentions were mediated by negative appraisals and threat emotions. Individuals with high health self-efficacy and positive outcome expectations of information search were more likely to manage uncertainty through information seeking. These results support the use of the CHIP model when perceptions of contradiction and decision uncertainty need to be accounted for, while also validating UMT for its original purposes. Model refinements and implications are discussed.

The role of disappointment aversion and expectation proclivity in describing financial risk aversion among financial decision-makers

PurposeUsing data obtained from 525 individuals who were surveyed during early spring 2020, this study addressed three aims: (1) to ascertain the degree to which disappointment aversion and expectation proclivity are related; (2) to identify who is most likely to exhibit patterns of disappointment aversion; and (3) to determine to what extent the combination of disappointment aversion and expectation proclivity is associated with financial risk aversion.Design/methodology/approachSeveral analytic methods were used in this study. Descriptive statistics were calculated for each of the measures examined in this study. Correlation, analysis of variance (ANOVA) and regression techniques were used to estimate associations between and among the variables of interest in this study.FindingsA negative relationship between disappointment aversion and expectation proclivity was noted, which is counter to conventional thinking. It is traditionally thought that those who establish high expectations will experience the greatest disappointment when choice outcomes fall below expectations. In this study, it was determined that when a financial decision-maker consistently establishes high outcome expectations and results fall below expectations, the financial decision-maker feels less disappointment. More precisely, those who consistently establish high expectations tend to be more disappointment tolerant than others.Research limitations/implicationsThis paper provides evidence that categories of disappointment aversion and expectation proclivity are associated with financial risk aversion and certain demographic characteristics.Practical implicationsThis paper adds support for assertions made in the International Journal of Bank Marketing (IJBM) that it is important for financial service professionals and bankers to manage customer expectations to reduce disappointment with products and services. This paper shows that combinations of disappointment aversion and expectation proclivity are related to the financial risk aversion of customers.Social implicationsFindings from this paper indicate that a commonly used heuristic that decision-makers should reduce expectations to avoid disappointment may not be accurate or particularly useful in the context of financial decision-making.Originality/valueFindings from this study add to the existing body of literature by showing that aversion to disappointment and the establishment of expectations, while distinct concepts, are interrelated.

Social anxiety levels and self-efficacy perceptions of adolescents with type-1 diabetes predict smoking outcome expectations: a cross-sectional study

ABSTRACT Background: An anti-smoking attitude should be established among adolescents with T1DM and adolescents’ smoking outcome expectations, anti-smoking self-efficacy levels, and social anxieties should be determined. Objectives: This study was carried out with the aim of to investigate the effects of social anxiety levels and self-efficacy perceptions of adolescents with T1DM on smoking outcome expectations. Methods: This study used a descriptive, correlational, and cross-sectional design. The researchers have complied with the guidelines of STROBE Checklist in presenting this studyThis study was conducted in İzmir, Turkey, with 210 adolescents diagnosed with T1DM who were registered at the pediatric endocrinology outpatient clinics of hospitals and were selected using the convenience sampling method between January and December 2019. Results: A significant relationship was found between self-efficacy and positive smoking expectation (r = 0.01) and anti-smoking (r = 0.57); between social anxiety and smoking r = (-0.05) and negative smoking expectation (r = 0.05). Also, a significant relationship was found between self-efficacy and anti-smoking (r = 0.57) and between social anxiety and anti-smoking (r = -0.05). Conclusion: Adolescents with high levels of self-efficacy had negative perceptions of smoking, therefore they had high negative smoking outcome expectations.

Frequencies and Predictors of Negative Effects in Routine Inpatient and Outpatient Psychotherapy: Two Observational Studies.

Negative effects of psychotherapy (NEP) include side effects, malpractice, and unethical behavior. Its setting-specific frequencies and predictors are mostly unknown. The two presented studies aim to investigate NEP and its predictors systematically across different treatment settings. In study 1, N = 197 patients of a German outpatient center were recruited, on average, 3.76 years after the termination of psychotherapy. In study 2, data from N = 118 patients of two German inpatient clinics were collected at admission (t0), discharge (t1), and 9-month follow-up (t2). All participants evaluated the negative effects of their previous out- or inpatient psychotherapy with the Inventory for the Balanced Assessment of Negative Effects in Psychotherapy and a priori hypothesized predictors. At least one side effect was reported by 37.3% of inpatients (t2) and 15.2% of outpatients. At least one case of malpractice and unethical behavior was reported by 28.8% of inpatients (t2) and 7.1% of outpatients. Inpatients reported significantly more side effects (U = 14347, z = 4.70, p < 0.001, r = 0.26) and malpractice and unethical behavior (U = 14168, z = 5.21, p < 0.001, r = 0.29) than outpatients. Rates of severe malpractice in the form of breaking confidentiality and physical and sexual abuse were less than 1% in both settings. Predictors of side effects were prior experience with psychotherapy and current interpersonal difficulties in the outpatient setting and higher motivation for psychotherapy (t0) in the inpatient setting. Predictors of malpractice and unethical behavior were younger age in the outpatient setting and poor therapeutic alliance, prior negative experience with malpractice and unethical behavior, and higher outcome expectations in the inpatient setting. NEP are common in both, in- and outpatient settings. Inpatients are at higher risk for the NEP than outpatients. To safeguard patients’ wellbeing, the systematic assessment and distinction of side effects and malpractice and unethical behavior should gain more attention in research and clinical practice.

Relations between attachment insecurity and role and outcome expectations for couple therapy

With the efficacy of couple therapy no longer in doubt, researchers are seeking to identify client characteristics that explain variability in retention and outcomes. We examined the link between two self‐reported characteristics, attachment insecurity and treatment expectations (for self, partner, and outcome), in a Mechanical Turk sample of 182 adults in committed relationships. A significant canonical correlation accounted for 27 per cent of the variance between the two sets of variables. Interpretation of the structure coefficients indicated that (1) low role expectations for one’s partner were predicted by high attachment anxiety; (2) low expectations for the outcome of couple therapy were predicted by high attachment avoidance coupled with low attachment anxiety; and (3) high self and outcome expectations were predicted by high attachment anxiety when attachment avoidance was low. We discuss the implications of these results for engaging couples with insecure attachment patterns.Practitioner points Expectations for couple therapy are measurable, and related to levels of attachment insecurity Results of this study underscore the importance of clinicians inquiring early on in treatment about what each partner anticipates about the process of couple therapy Clinicians should work gently and creatively with clients with low expectations to help them safely engage in the treatment process Recognising attachment insecurity should be a signal to clinicians to monitor relevant attachment behaviours and related expectations

Baseline Psychosocial and Demographic Factors Associated with Study Attrition and 12-Month Weight Gain in the DIETFITS Trial.

The purpose of this study was to examine correlates of failure-trial attrition and weight gain-in a randomized clinical weight-loss trial. The Diet Intervention Examining The Factors Interacting with Treatment Success (DIETFITS) trial included 609 adults (18-50 years; BMI 28-40). Participants were randomized to a 12-month healthy low-fat or healthy low-carbohydrate diet for weight loss. At baseline, participants completed psychosocial, demographic, and anthropometric measures. Stepwise logistic regressions identified baseline factors associated with (1) study attrition and (2) among trial completers, weight gain at 12 months. Having higher baseline food addiction and self-efficacywas linked to treatment failure. Being younger, not having a college education, having higher outcome expectations and quality of life, and having lower social functioning and self-control increased the odds of trial attrition. Identifying as other than non-Hispanic white; not being married or cohabitating; having higher cognitive restraint and self-control; and having lower amotivation, family encouragement, and physical limitations increased the odds of gaining weight by treatment's end. Participants' baseline psychosocial and demographic factors may support or impede successful weight loss. Trialists should attend to these factors when designing treatments in order to promote participants' likelihood of completing the trial and achieving their weight-loss goals.

Neural mechanisms of expectancy-based placebo effects in antidepressant clinical trials

BackgroundPatient expectancy of therapeutic improvement is a primary mediator of placebo effects in antidepressant clinical trials, but its mechanisms are poorly understood. This study employed a novel antidepressant trial design, with integrated functional magnetic resonance imaging (fMRI), to manipulate patient outcome expectancy and examine its neural mediators. MethodTwenty-three depressed outpatients, in a randomized controlled trial were assigned to either Open (high outcome expectancy) or Placebo-controlled (low outcome expectancy) treatment with citalopram for eight weeks. fMRI scans were acquired before and after the expectancy manipulation (before medication treatment), while participants performed a masked emotional face task. Focusing on an amygdala region-of-interest (ROI), we tested a model where reduction in amygdala activation mediated outcome expectancy effects on the slope of change in depressive symptoms. ResultsFollowing the manipulation, significant differences between conditions were found in neural activation changes in the amygdala, as well as in superior temporal gyrus, insula, and thalamus. Findings support the proposed mediation model according to which activation in the left amygdala ROI decreased significantly in the Open as opposed to the Placebo-controlled group following randomization (p = 0.009) for sad vs. neutral face contrast. The reduced left amygdala activation, in turn, was a significant predictor of decreased depressive symptoms during the trial (p = 0.007), and the mediation model was significant. ConclusionsResults from this study, the first designed to identify the neural mechanisms of expectancy augmentation in an antidepressant randomized control trial, suggest that therapeutic modulation of amygdala activity may be an important pathway by which patient outcome expectancy influences depressive symptoms. Clinicaltrials.gov identifierNCT01919216; Trial name: Placebo Effects in the Treatment of Depression: Cognitive and Neural Mechanisms, URL: https://clinicaltrials.gov/ct2/show/NCT01919216

The Feasibility and Impact of the EMOVE Intervention on Self-efficacy and Outcome Expectations for Exercise in Epilepsy.

The purpose of this pilot study was to evaluate the feasibility of the self-efficacy based Epilepsy-Motivate and Outcome Expectations for Vigorous Exercise (EMOVE) intervention and report on the preliminary efficacy of this intervention aimed at improving exercise behaviors in adults with epilepsy. Methods: A single-group, repeated-measures design was used in 30 outpatients. Data were collected at baseline and 12 weeks after the intervention. Participant outcomes included Self-Efficacy and Outcome Expectations for Exercise in Epilepsy, Beck Depression Inventory-II, Quality of Life in Epilepsy Inventory-31, seizure frequency, average daily steps, and body mass index. Daily number of steps was measured using a wrist-worn activity monitor. Feasibility data were assessed using evidence of treatment fidelity including intervention delivery, receipt, and enactment. Results: Participants were single (63%), white (53%), female (63%), had a mean (SD) age of 46.7 (13) years (range, 26-68 years), had low levels of self-efficacy (mean, 5.10; range, 0-10) and high outcome expectations (mean, 3.90; range, 0-5), took under the recommended 10 000 steps per day (mean, 5107), and had an average of 6 seizures per month. Postintervention testing showed statistical improvement in depressive symptoms (mean [SD], 9.95 [9.47]; P < .05). There were no significant differences found for the other study outcomes. Our study showed the EMOVE intervention was feasible. Study participants had improved depressive symptoms. Future research should focus on increasing the sample size, improving exercise performance through group or individualized exercise sessions, and adding a control group to better evaluate the relationship between the intervention and improved depressive symptoms.

The Fix-it face-to-face intervention increases multihazard household preparedness cross-culturally.

Vulnerability to natural disasters is increasing globally1-3. In parallel, the responsibility for natural hazard preparedness has shifted to communities and individuals4. It is therefore crucial that households increase their preparedness, yet adoption of household preparedness measures continues to be low, even in high-risk regions5-8. In addition, few hazard-preparedness interventions have been evaluated longitudinally using observational measures. Therefore, we conducted a controlled intervention with a 12-month follow-up on adults in communities in the United States and Turkey that focused on improving household earthquake and fire preparedness. We show that this Fix-it intervention, involving evidence-based, face-to-face workshops, increased multihazard preparedness in both cultures longitudinally. Compared to baseline, the primary outcome-overall preparedness-increased significantly in the intervention groups, with more improvement in earthquake preparedness in the Turkish participants and more improvements in fire preparedness in the US participants. High baseline outcome expectancy and home ownership predicted overall preparedness change in both intervention groups longitudinally, implying that a sense of agency influences preparedness. An unintended consequence of observation is that it may increase preparedness, as even the control groups changed their behaviour. Therefore, observation of home preparatory behaviours by an external source may be a way to extend multihazard preparedness across a population.

Fear of falling in sensory impaired nursing home residents

Objectives: Fear of falling (FOF) causes excess disability in nursing home (NH) residents and is associated with vision and hearing impairment. We explored factors associated with FOF in 225 NH residents with vision, hearing or dual sensory impairment.Methods: We explored age, gender, cognition, depression, social engagement, illness burden, falls, physical function, mobility, falls self-efficacy and outcome expectancy as predictors of FOF using univariate logistic regression modeling, followed by multivariate analysis by group (visual, hearing, dual, total sample).Results: Fifty-one percent of residents had FOF. Residents who had FOF reported better cognition, lower falls self-efficacy, and higher outcome expectancy in the total sample and in most impairment groups. Falls outcome expectancy predictedFOF in the total sample and in the visual and hearing sensory impairment groups.Conclusion: When addressing FOF in NH residents it is important to address sensory status along with fears about falling to promote function.

Time preference, outcome expectancy, and self-management in patients with type 2 diabetes.

BackgroundPatient self-management is crucial to prevent complications and mortality in type 2 diabetes. From an economic perspective, time preference predicts short-sighted decision making and thus might help to explain non-adherence to self-anagement recommendations. However, recent studies on this association have shown mixed results.PurposeIn this study, we tested whether the combination of time preference and outcome expectancy can improve the predictions of self-management behavior.Patients and methodsData from 665 patients with type 2 diabetes were obtained from the cross-sectional KORA (Cooperative Health Research in the Region of Augsburg) GEFU 4 study. Time preference and outcome expectancy were measured by one question each, which were answered on a 4-point Likert scale. Their association with six self-managing behaviors was tested in logistic and linear regression analyses. Likewise, we examined the association between self-management and the interaction of outcome expectancy and time preference.ResultsA high time preference was associated with a significantly lower sum of self-management behaviors (β=−0.29, 95% CI [−0.54, −0.04]). Higher outcome expectancy was associated with a higher self-management score (β=0.21, 95% CI [−0.03, 0.45]). The interaction model showed that low time preference was only associated with better self-management when combined with a high outcome expectancy (β=0.05, 95% CI [−0.28, 0.39] vs β=0.27, 95% CI [−0.09, 0.63]).ConclusionTime preference and outcome expectancy are interrelated predictors of patient self-management and could be used to identify and to intervene on patients with a potentially poor self-management.

Cognitive factors predict medication adherence and asthma control in urban adolescents with asthma.

PurposeAdolescents with asthma often report poor medication adherence and asthma control. Cognitive factors embedded in the social cognitive theory including self-efficacy, outcome expectations, and barrier perceptions may explain poor asthma outcomes in this population. This study was performed to examine the extent to which these cognitive factors are intercorrelated and explain medication adherence and asthma control in urban adolescents.Patients and methodsA total of 373 urban adolescents (12–20 years) with asthma completed questionnaires measuring asthma-related self-efficacy, outcome expectations, barrier perceptions, medication adherence, and asthma control. Multiple linear regression was conducted to examine the extent to which the three cognitive factors predicted medication adherence and asthma control after controlling for covariates including age, sex, household income, and age at diagnosis.ResultsParticipants’ ages were on average 14.68 (±1.94) years; 50% were female, and most (78.6%) were African American. Higher self-efficacy associated with lower barrier perceptions and higher outcome expectations (r=0.50, p<0.001; r=−0.26, p<0.001, respectively). Self-efficacy predicted better asthma control (B=−0.098, p=0.004) and adherence (B=0.426, p=0.011), whereas barrier perceptions predicted poorer asthma control (B=0.13, p<0.001) and adherence (B=−0.568, p<0.001). Self-efficacy independently predicted fewer missed doses (B=−0.621, p=0.006), and barrier perception independently predicted asthma control (B=0.12, p<0.001) and adherence (B=−0.519, p<0.001).ConclusionImproving medication adherence and asthma control among adolescents may require a multifaceted approach. Interventions focused on increasing self-efficacy and addressing barriers, actual or potential, to medication adherence could ameliorate asthma disparities in urban adolescents.