Several recommendations for improving adherence assessment were made. In particular, consideration should be given to the use of innovative technologies that provide a window into the "real time" behaviors of patients and families. Providing written treatment plans, identifying barriers to good adherence, and examining racial and ethnic differences in attitudes, beliefs and behaviors affecting adherence were strongly recommended.

There are a number of strong measures for assessing children's pain, which allows professionals options to meet their particular needs. Future directions in pain assessment are identified, such as highlighting culture and the impact of pain on functioning. This review examines the research and characteristics of some of the commonly used pain tools in hopes that the reader will be able to use this evidence-based approach and the information in future selection of assessment devices for pediatric pain.

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These results offer preliminary support for parent-delivered massage therapy as an intervention for SCD pain.

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Future studies will need to develop adequate definitions of adherence, accurate methods of assessing adherence, and appropriate designs to evaluate multicomponent treatment programs to advance interventions to the "well-established" category.

Purpose-The purpose of the study was to examine perceived barriers to clinic attendance and strategies to overcome these barriers for adolescents with sickle cell disease (SCD).Materials and Methods-This was a two-phased study which utilized focus groups (n = 13) and individual semi-structured interviews (n = 32) with adolescent patients (aged 13-21 years) from three pediatric sickle cell clinics in the Mid-west.Results-Adolescents identified competing activities, health status, patient-provider relationships, adverse clinic experiences, and forgetting as barriers to clinic attendance. Calendars/ reminders and parent reminders were the most commonly reported strategies to facilitate clinic attendance. Adolescents also reported the need for flexible scheduling and improved patientprovider communication.Discussion-Adolescents with SCD and their families may benefit from on-going education about the importance of attending routine clinic visits. Adherence to clinic appointments for adolescents may be enhanced by developing interventions to decrease forgetting (e.g., phone call reminders, text-messaging) and increase patient satisfaction with clinic visits. Scheduling appointments to accommodate busy schedules/scheduling conflicts (e.g., late clinic hours), providing teen-friendly clinic environments and utilizing technology may also facilitate attendance.

Asthma is a common chronic illness of childhood that requires coordinated efforts by children, families, and health care professionals for proper medical management. The medical management of pediatric asthma involves pharmacological and behavioral recommendations to both prevent and control asthma attacks. However, management of these attacks is hindered by failure to adhere to the prescribed recommendations. While the literature on adherence in pediatric asthma has grown over the past 10 years, few definitive statements can be made about causes and treatment. Various issues related to adherence and pediatric asthma are reviewed in this paper, including assessment methods, factors influencing adherence, and treatment strategies. Recommendations for future research are provided, starting with more controlled randomized studies.