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Development and validation of the Adolescent Asthma Self-Efficacy Questionnaire (AASEQ)

Holley S, Knibb R, Latter S, et al.

Eur Respir J 2019;54:1801375

DOI: 10.1183/13993003.01375-2018

Self-efficacy is defined as a personal judgement of how well one can execute courses of action required to deal with prospective situations. Individuals who have high self-efficacy are more likely to perform actions that will leads to successful results, whereas those with low self-efficacy are more likely to cease effort early and fail. Good self-efficacy with respect to asthma self-management is associated with better health outcomes. However, there are no well-validated tools to measure asthma self-management self-efficacy in adolescents.

Holley and colleagues set out to develop and validate an Adolescent Asthma Self-Efficacy Questionnaire (AASEQ).

A prototype scale was developed through a review of the literature, interviews with adolescents with asthma and consultations with parents and healthcare professionals. The reliability and validity of the prototype scale was then assessed in another group of adolescents, who completed the prototype, General Self-Efficacy and KidCOPE scales to assess to measure coping mechanisms and proficiency of asthma management alongside self-efficacy. Subjects were retested to assess the longitudinal validity of the prototype scale.

The interview stage with stakeholders (n=28) resulted in a 38-item prototype scale covering medication, symptom management, triggers, knowledge, attitudes and beliefs around asthma, supportive relationships, school and healthcare professionals. 243 adolescents completed the 38-item scale. Factors and reliability analysis reduced the prototype scale to 27 items with four sections: symptom management; medication; friends, family and school; and asthma beliefs. The internal validity of the 27-item scale was respectable to excellent (α’s 0.78–0.91). In subjects who completed it twice (n=63), results were stable over time (intra-class correlation = 0.82). Better adolescent self-efficacy was associated with better general self-efficacy and indicators of better asthma management.

The AASEQ represents a well-validated tool that could aid future research and practice focussed on asthma self-management in adolescents. Furthermore, the AASEQ could potentially be used as an intermediate outcome measure to assess the impact of behavioural interventions in adolescents.

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