Parental factors in medical decision-making for their children with functional abdominal pain disorder: Testing the utility of the Health Belief Model

Abstract

Introduction: Childhood functional abdominal pain disorders (FAPD) affect approximately 13.5% of children and can result in significant functional impairment (Nightingale & Sharma, 2020). Multidisciplinary programs including medical and psychological treatments have been found to improve outcomes compared to medical treatment alone. It is known that parents play a majority role in decision-making for pediatric patients, especially when they are younger. Furthermore, the Health Belief Model (HBM) has been previously conceptualized as a decision-making model for one’s own engagement in treatment and has also been used to assess parent beliefs about pediatric care aspects, such as childhood vaccination choice (Chen et al., 2011). This study investigated a potential proxy decision-making model utilizing theoretical aspects of the HBM. Methods: A sample of 501 parent participants were recruited via Prime Panels, an online survey software. Parents were eligible if they had a child under the age of 18 who was currently diagnosed with a FAPD. A series of surveys, including the Parent Psychological Flexibility Questionnaire, Big-Five Inventory, and an adaptation of the Champion (1984) Health Belief Model Scale, including perceived susceptibility, severity, and threat, perceived benefits/barriers, parent and physician knowledge, and parent-physician communication were administered. Results: Parents who had not heard of multidisciplinary care reported still being open to receiving these services for their child. Furthermore, aspects of the HBM, including perceived susceptibility, severity and threat, perceived benefits, modifying factors such as parent psychological flexibility, and cues to action such as parent-physician communication significantly predicted consideration and acceptance of multidisciplinary and psychological care Discussion: This adaptation of the HBM scale predicted parental consideration and acceptance of multidisciplinary care and thus indicates potential utility as a clinical tool for aiding clinicians in “pre-treatment” decision-making. That is, assessment using the theoretical structure of the HBM of parents’ beliefs regarding their child’s diagnosis may help clinicians better understand how they can best help the family during the treatment decision-making process. Conclusion: Future studies should analyze the potential utility of a short-form Health Belief Model Scale to be implemented in pediatric settings at the point of functional abdominal pain diagnosis in order to increase parental use of multidisciplinary treatments for their children.