Adolescent risk preference and asthma symptom self-management: Assessing symptom management scenarios

Abstract

Adolescent asthma symptom self-management choices frequently involve uncertain outcomes that include potential dangers such as trigger exposures or delays in treatments that can lead to increased morbidity or mortality. Nurses must understand factors that influence how adolescents make symptom decisions. The purpose of the investigation was to assess eight adolescent asthma symptom scenarios for use with the standard gamble technique (SGT) for making choices. The aims were to: (1) estimate the internal consistency and content validity of the scenarios; (2) estimate the relationship between measured risk preferences, age, and gender; and (3) describe adolescent responses to using the SGT. Thirty-six adolescents participated. Risk preferences or utilities elicited during face-to-face interviews with 31 adolescents were used to answer research questions. Data were analyzed using descriptive statistics, Cronbach's alpha, Kendall's tau correlations, and point biserial correlations. Content validity (CV) ratings from 36 adolescents were used to compute indexes and establish CV of the scenarios. Qualitative responses were analyzed using a modified case study strategy to further establish CV and assess using SGT with adolescents. The estimates of internal consistency reliability and relationships between utilities, age, and gender were limited by the non-normal distributions of utility and age data sets and small sample size. The standardized alpha was .70 for the eight-scenario composite. Eight significant inter-item correlations and seven significant item-total correlations were identified. One significant correlation between age and an individual scenario utility score was found. No significant relationships between age and mean utility scores or gender and the individual or mean utility scores were seen. The CV indexes support the relevancy of the content of the eight-scenario composite as evidenced by 94.5% of the adolescents rating the individual scenarios as CV for the domains and 92% for the risk areas. In addition, the adolescents rated 94% percent of the composites as CV. The qualitative responses support the quantitative data and describe the SGT as a method that adolescents can use. Future studies are needed with a larger sample to further examine the internal consistency of the scenarios and the relationships between age, gender, and utility scores measured with the SGT.