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A randomized, controlled trial of a community-based support program for families of children with chronic illness: pediatric outcomes. (in depth).

Children with chronic illnesses, who are at increased risk of developing mental health problems, can reduce that risk by participating in community-based support programs, according to a recent study.

Conducted in Baltimore, MD, the study involved 136 mothers and children aged seven to eleven years. Each of the children had one of four conditions: diabetes mellitus, sickle cell anemia, cystic fibrosis, or moderate to severe asthma.

The study included a control group, and used four methods of mental health evaluation. These were the Personal Adjustment and Role Skills Scale III, the Self-Perception Profile for Children, the Revised Children's Manifest Anxiety Scale, and the Children's Depression Inventory.

The 15-month, community-based program was provided by child life specialists and "experienced mothers." It included contact through telephone calls, face-to-face meetings, and special events involving the family. Child and parent mental health reports were taken as they entered the study, then one year later, to determine mental health at baseline and any changes that took place during the study period.

A cutoff score was chosen to indicate maladjustment; the experiment found that the percentage of children in the control group who fell in the maladjustment range at baseline increased from 15 percent to 21 percent over the course of the project. Conversely, the percentage of children in the experimental group who fell in the maladjustment range was nearly cut in half: 19 percent of experimental group children fell in the maladjustment range at the beginning, compared to 10 percent by the end. In particular, children with low physical self-esteem at the be-ginning of the program experienced a more pronounced effect than children whose physical self-esteem was moderate to high before the intervention project.

The experiment showed that family support intervention has positive effects in promoting mental health and adjustment in children with these four chronic health conditions, and especially in children with low physical self-esteem. Because the program was comparably helpful to children with each of the four disorders included in the experiment, the results suggest that this type of community-based intervention may be helpful to children with all kinds of chronic illnesses.

The experiment was conducted by Robin G. Chernoff, MD, Henry T. Ireys, PhD, Katherin A. DeVet, PhD, and Young J. Kim, PhD.

For more information on the experiment, visit issues/v156n6/abs/poa10379. html or contact Robin G. Chernoff, MD, Department of Pediatrics, The Johns Hopkins School of Medicine, 600 N Broadway, Baltimore, MD 21287 (e-mail:
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Author:Chernoff, Robin; Ireys, Henry T.; DeVet, Katherin A.; Kim, Young J.
Publication:The Exceptional Parent
Date:Nov 1, 2002
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