Who you ask about health self-efficacy matters: Parental perceptions and youth reports are associated with different outcomes in a sample with chronic health conditions
Restricted accessResearch articleFirst published online 2026
Who you ask about health self-efficacy matters: Parental perceptions and youth reports are associated with different outcomes in a sample with chronic health conditions
This study examined the psychometric properties of a youth-reported health self-efficacy measure and new parent-reported health self-efficacy measure in a sample of adolescents and young adults (AYAs) with chronic illnesses. This study also considered whether parents’ perspectives on AYAs’ health self-efficacy explained outcomes above AYA-reported health self-efficacy. A sample of 54 AYAs (range = 12–17 years, M = 17.8, SD = 2.58) completed measures of health self-efficacy and treatment adherence. Parents (N = 48) reported on AYA health self-efficacy and transition readiness. Good psychometric properties were shown for both measures. Parents’ perspectives predicted transition readiness above and beyond AYAs’ self-reported health self-efficacy, AYA age, and AYA education. Whereas treatment adherence was significantly predicted by AYA-reported self-efficacy and did not have significantly more variance explained by parents’ perspectives. Results highlight the importance of considering different perspectives to achieve optimal outcomes when treating youth with chronic conditions during transition care.
BohannyWWuSFVLiuCY, et al. (2013) Health literacy, self-efficacy, and self-care behaviors in patients with type 2 diabetes mellitus. Journal of the American Association of Nurse Practitioners25(9): 495–502. https://doi.org/10.1111/1745-7599.12017
3.
BravoLKillelaMKReyesBL, et al. (2020) Self-management, self-efficacy, and health-related quality of life in children with chronic illness and medical complexity. Journal of Pediatric Health Care34(4): 304–314. https://doi.org/10.1016/j.pedhc.2019.11.009
4.
CampbellFBiggsKAldissSK, et al. (2016) Transition of care for adolescents from paediatric services to adult health services. Cochrane Database of Systematic Reviews4: Article CD009794. https://doi.org/10.1002/14651858.CD009794.pub2
5.
CampagnaBRWeatherleyKShermeshE, et al. (2020) Adherence to medication during transition to adult services. Pediatric Drugs22(5): 501–509. https://doi.org/10.1007/s40272-020-00414-2
6.
CaplinDAustinJKDunnDW, et al. (2002) Development of a self-efficacy scale for children and adolescents with epilepsy. Children’s Health Care31(4): 295–309. https://doi.org/10.1207/S15326888CHC3104_3
7.
CarlsenKHaddadNGordonJ, et al. (2017) Self-efficacy and resilience are useful predictors of transition readiness scores in adolescents with inflammatory bowel diseases. Inflammatory Bowel Diseases23(3): 341-346. https://doi.org/10.1097/MIB.0000000000001038
8.
CohenSEHooperSRJavalkarK, et al. (2015) Self-management and transition readiness assessment: concurrent, predictive and discriminant validation of the STARx questionnaire. Journal of Pediatric Nursing30(5): 668–676. https://doi.org/10.1016/j.pedn.2015.05.006
9.
de WinterJCDodouDWieringaPA (2009) Exploratory factor analysis with small sample sizes. Multivariate Behavioral Research44(2): 147–181. https://doi.org/10.1080/00273170902794206
10.
DrovettaMCramerELinafelterA, et al. (2022) Impact of perceived barriers on patient engagement and attitudes towards transition and transfer. Children9(9): Article 1273. https://doi.org/10.3390/children9091273
11.
EatonCKEakinMNCoburnS, et al. (2019) Patient health beliefs and characteristics predict longitudinal antihypertensive medication adherence in adolescents with CKD. Journal of Pediatric Psychology44(1): 40–51. https://doi.org/10.1093/jpepsy/jsy073
12.
EiserCMorseR (2001) Can parents rate their child’s health-related quality of life? Results of a systematic review. Quality of Life Research10(4): 347–357. https://doi.org/10.1023/A:1012253723272
13.
EmersonNDMorrellHERMahtaniN, et al. (2018) Preliminary validation of a self-efficacy scale for pediatric chronic illness. Child Care Health and Development44: 485–493. https://doi.org/10.1111/cch.12551
14.
EngelMLBarnesAJHenryTR, et al. (2019) Medical risk and resilience in adolescents and young adults with epilepsy: The role of self-management self-efficacy. Journal of Pediatric Psychology44(10): 1224–1233. https://doi.org/10.1093/jpepsy/jsz063
15.
GauciJBloomfieldJLawnS, et al. (2021) Effectiveness of self-management programmes for adolescents with a chronic illness: A systematic review. Journal of Advanced Nursing77: 3585–3599. https://doi.org/10.1111/jan.14801
16.
GenetiYWondwossenKAdimasuM, et al. (2022) Adherence to diabetes self-management and its associated factors among adolescents living with type 1 diabetes at public hospitals in Addis Ababa, Ethiopia: A cross-sectional study. Diabetes, Metabolic Syndrome and Obesity15: 659–670. https://doi.org/10.2147/dmso.S350168
17.
GillelandJAmaralSMeeL, et al. (2012) Getting ready to leave: Transition readiness in adolescent kidney transplant recipients. Journal of Pediatric Psychology37(1): 85–96. https://doi.org/10.1093/jpepsy/jsr049
18.
GoethalsERCommissariatPVVolkeningLK, et al. (2020) Assessing readiness for independent self-care in adolescents with type 1 diabetes: Introducing the RISQ. Diabetes Research and Clinical Practice162: Article 108110. https://doi.org/10.1016/j.diabres.2020.108110
19.
Goldstein-LeeverAPeughJLQuinnCT, et al. (2020) Disease self-efficacy and health-related quality of life in adolescents with sickle cell disease. Journal of Pediatric Hematology/Oncology42(2): 141–144. https://doi.org/10.1097/mph.0000000000001363
20.
GumidyalaAPGreenleyRNPlevinskyJM, et al. (2018) Moving on: Transition readiness in adolescents and young adults with IBD. Inflammatory Bowel Disease24(3): 482–489. https://doi.org/10.1093/ibd/izx051
21.
GürcanMTuranSA (2022) Testing the psychometric properties of the Turkish culture version of the self-efficacy scale for pediatric chronic illness. Current Psychology41: 6375–6385. https://doi.org/10.1007/s12144-020-01134-z
22.
HaysRDKravitzRLMazelRM, et al. (1994) The impact of patient adherence on health outcomes for patients with chronic disease in the medical outcomes study. Journal of Behavioral Medicine17(4): 347–360. https://doi.org/10.1007/BF01858007
23.
IannottiRJSchneiderSNanselTR, et al. (2006) Self-efficacy, outcome expectations, and diabetes self-management in adolescents with type 1 diabetes. Developmental and Behavioral Pediatrics27(2): 98–105. https://doi.org/10.0196-206X/06/2702-0098
24.
IzaguirreMRTaftTKeeferL (2017) Validation of a self-efficacy scale for adolescents and young adults with inflammatory bowel disease. Journal of Pediatric Gastroenterology and Nutrition65(5): 546–550. https://doi.org/10.1097/mpg.0000000000001552
KingPSBergCAButnerJ, et al. (2014) Longitudinal trajectories of parental involvement in type 1 diabetes and adolescents’ adherence. Health Psychology33(5): 424–432. https://doi.org/10.1037/a0032804
27.
KwokCWallerDKohnM, et al. (2025) The impact of perceived self-efficacy on healthcare transition outcomes: Perceptions from parents and young people. Child: Care, Health and Development51(4): e70125. https://doi.org/10.1111/cch.70125
28.
NoserAEHuffhinesLClementsMA, et al. (2017) Diabetes conflict outstrips the positive impact of self-efficacy on youth adherence and glycemic control in type 1 diabetes. Pediatric Diabetes18(7): 614–618. https://doi.org/10.1111/pedi.12471
29.
OttJGreeningLPalardyN, et al. (2000) Self-efficacy as a mediator variable for adolescents’ adherence to treatment for insulin-dependent diabetes mellitus. Children’s Health Care29(1): 47–63. https://doi.org/10.1207/S15326888CHC2901_4
30.
RheeHLoveTHarringtonD, et al. (2020) Comparing three measures of self-efficacy of asthma self-management in adolescents. Academic Pediatrics20(7): 983–990. https://doi.org/10.1016/j.acap.2020.03.001
31.
SabateE (2003) Adherence to Long Term Therapies: Evidence for Action. World Health Organization.
32.
SattoeJNvan StaaAMollHA (2012) The proxy problem anatomized: Child-parent disagreement in health related quality of life reports of chronically ill adolescents. Health and Quality of Life Outcomes10: 10. https://doi.org/10.1186/1477-7525-10-10
33.
SawickiGSKelemenSWeitzmanER (2014) Ready, set, stop: Mismatch between self-care beliefs, transition readiness skills, and transition planning among adolescents, young adults, and parents. Clinical Pediatrics53(11): 1062–1068. https://doi.org/10.1177/0009922814541169
SilvaKMillerVA (2020) Does self-efficacy mediate the link between impulse control and diabetes adherence?Journal of Pediatric Psychology45(4): 445–453. https://doi.org/10.1093/jpepsy/jsaa007
36.
StupianskyNWHannaKMSlavenJE, et al. (2013) Impulse control, diabetes-specific self-efficacy, and diabetes management among emerging adults with type 1 diabetes. Journal of Pediatric Psychology38(3): 247–254. https://doi.org/10.1093/jpepsy/jss110
37.
TreadwellMJohnsonSSislerI, et al. (2016) Self-efficacy and readiness for transition from pediatric to adult care in sickle cell disease. International Journal of Adolescent Medicine and Health28(4): 381–388. https://doi.org/10.1515/ijamh-2015-0014
38.
UzarkKSmithCDonohueJ, et al. (2015) Assessment of transition readiness in adolescents and young adults with heart disease. Jornal de Pediatria167(6): 1233–1238. https://doi.org/10.1016/j.jpeds.2015.07.043
39.
van StaaAvan der StegeHAJedelooS, et al. (2011) Readiness to transfer to adult care of adolescents with chronic conditions: Exploration of associated factors. Journal of Adolescent Health48: 295–302. https://doi.org/10.1016/j.jadohealth.2010.07.009
VartyMPopejoyLL (2020) A systematic review of transition readiness in youth with chronic disease. Western Journal of Nursing Research42(7): 554–566. https://doi.org/10.1177/0193945919875470
42.
VartyMSpeller-BrownBWakefieldBJ, et al. (2022) Decision-making involvement, self-efficacy, and transition readiness in youth with sickle cell disease. Nursing Research71(1): 12–20. https://doi.org/10.1097/NNR.0000000000000550
43.
VerheyLHKulikDMRonenGM, et al. (2009) Quality of life in childhood epilepsy: What is the level of agreement between youth and their parents?Epilepsy & Behavior14(2): 407–410. https://doi.org/10.1016/j.yebeh.2008.12.008
44.
VillaécijaJLuqueBCastillo-MayénR, et al. (2023) Influence of family social support and diabetes self-efficacy on the emotional wellbeing of children and adolescents with type 1 diabetes: A longitudinal study. Children10(7): 1196. https://doi.org/10.3390/children10071196
45.
WiebeDJChowCMPalmerDL, et al. (2014) Developmental processes associated with longitudinal declines in parental responsibility and adherence to type 1 diabetes management across adolescence. Journal of Pediatric Psychology39(5): 532–541. https://doi.org/10.1093/jpepsy/jsu006
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
