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Early Childhood Asthma Intervention in Historical, Social, and Cultural Context
Unformatted Document Text:  6 knowledge or ability, stuborness, or demographic characteristics, “non-compliance” may result from larger social forces and/or patients’ superior knowledge about them. Hence, interactionists have called for a more patient-centered view of health behavior that allows individuals to define their own treatment needs and goals. As a result, paradigm shift within the health behavior literature has begun. Academics have been moving from medical models of “compliance” to a patient-centered perspective of “adherence” (Burton and Hudson 2001). The principles of the new paradigm greatly affect the conceptualization and design of this study. Although the data for this study come from the program employees’ notes, the analysis is closely allied with a patient-centered approach. Rather than investigating the specific outcomes and objectives usually emphasized by funding agencies and health researchers, I am concerned with families’ abilities to continue participation in the program. Therefore, I exclusively consider families who have shown a strong desire to participate in the program; and I use this “patient-identified” goal as the outcome of interest. Hence, the primary research question is: what disrupts the participation of families that value involvement in the program? My intention is to better understand the reasons for different levels of participation, rather than to understand “non-compliance,” per se. Life Course Perspective The life course perspective greatly influenced the approach used to answer this research question. One of the major premises of the life course perspective is that individual experiences are influenced by social and historical conditions. In particular, the perspective draws attention to the principles of contextualism and life stages.

Authors: Leech, Tamara.
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knowledge or ability, stuborness, or demographic characteristics, “non-compliance” may
result from larger social forces and/or patients’ superior knowledge about them.
Hence, interactionists have called for a more patient-centered view of health
behavior that allows individuals to define their own treatment needs and goals. As a
result, paradigm shift within the health behavior literature has begun. Academics have
been moving from medical models of “compliance” to a patient-centered perspective of
“adherence” (Burton and Hudson 2001).
The principles of the new paradigm greatly affect the conceptualization and
design of this study. Although the data for this study come from the program employees’
notes, the analysis is closely allied with a patient-centered approach. Rather than
investigating the specific outcomes and objectives usually emphasized by funding
agencies and health researchers, I am concerned with families’ abilities to continue
participation in the program. Therefore, I exclusively consider families who have shown
a strong desire to participate in the program; and I use this “patient-identified” goal as the
outcome of interest. Hence, the primary research question is: what disrupts the
participation of families that value involvement in the program? My intention is to better
understand the reasons for different levels of participation, rather than to understand
“non-compliance,” per se.
Life Course Perspective
The life course perspective greatly influenced the approach used to answer this
research question. One of the major premises of the life course perspective is that
individual experiences are influenced by social and historical conditions. In particular,
the perspective draws attention to the principles of contextualism and life stages.


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