The role of effective communication with children and their families in fostering adherence to pediatric regimens

Adherence to pediatric health enhancement, disease prevention, and medical treatment, particularly for chronic disease, can be challenging because of demanding regimens, children's progressing developmental stages, and varying family perspectives and relationships. This review examines adherence in the context of communication among providers, pediatric patients, and their families. The focus is on: the delivery of prevention and treatment information; trust in the therapeutic relationship; beliefs and attitudes in shaping acceptance of health care messages; social and cultural norms; building patient and family commitment to behavior change; family habits; barriers and pressures faced by patients and their families; the role of social networks and social support in fostering adherence, and the effects of family cohesiveness and family conflict. The unique challenges of fostering preventive health care and treatment for chronic disease in the context of transition to adolescence are also considered, and effective clinical solutions are reviewed. (C) 2004 Elsevier Ireland Ltd. All rights reserved.