Date Approved

8-26-2008

Date Posted

11-15-2009

Degree Type

Open Access Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department or School

Psychology

Committee Member

Flora Hoodin, Ph.D., Chair

Committee Member

Michelle Byrd, Ph.D.

Committee Member

Jennifer Rice, Ph.D.

Committee Member

Thomas Schmitt, Ph.D.

Abstract

An important challenge physicians encounter when treating adolescent patients with moderate scoliotic curves is that the adolescents may not wear the brace as prescribed or long enough for the brace to be effective. The present investigation used electronic monitoring and temperature probes to investigate whether the adolescents were wearing their brace during events identified using a modified Daily Reconstruction Method for six randomly selected days over a 14-day period. It was hypothesized that environmental, interpersonal, and intrapersonal variables during the events would be predictive of objective brace-wear across and within participants, and patterns of significant variables would differ from subjective reports of brace-wearing. Participants were nine ethnically diverse adolescents (two male, seven females) with a mean age of 13.25 years, who provided 47 – 81 events each for a total of 567 observations. When analyzing whether the adolescents were wearing their braces during events, the results of a logistic regression across participants suggests adolescents did not wear their braces when participating in physical activities, when with parents and non-related adults, during hygiene activities, and when in a more negative mood. As a group, the adolescents in this study were more likely to wear their brace when they were studying at school and when they feel competent. For individuals, other variables, such as riding in vehicles, eating, shopping, and comfort were associated with not wearing their brace. The main discrepancies in objective and subjective measures of whether they were wearing their brace-wearing were intrapersonal situations. The adolescents were less likely to not report not wearing their brace when they were in a more negative mood, and but were more likely to when they were uncomfortable. Importantly, this investigation was successful at pioneering a replicated single-case design to assess both objectively measured brace-wearing and environmental, interpersonal, and intrapersonal psychosocial variables within and across participants. This innovative use of DRM methodology is generalizable to research investigating a wide array of adherence behaviors and measuring their predictors proximally in time but without reactivity typically caused by interrupting ongoing activities.

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