November 1, 2021
By Sophy Perdomo, PhD & Nicole Brainard, PhD, MPH
Knowing parents’ values for their children provides you with valuable information about what motivates them, which in turn can inform which behaviors they are likely to engage in and adhere to long term.
Have you ever wondered whether the conversations you have with parents impact their children’s adherence or health outcomes? Quality conversations with parents (and their children when appropriate) can not only enhance your relationships with them but are also associated with increased treatment adherence and improved health outcomes.1 Throughout the conversation and the decision-making process, children should be encouraged to participate in a developmentally appropriate manner. The focus of this article is, however, on parent-centered discussions.2
The Johnson & Johnson Behavioral Science and Johnson & Johnson Vision Myopia teams have partnered to deploy a set of best practices for high quality patient-provider conversations. As part of that effort, we are going to share with you two of those practices that would be beneficial to incorporate in your conversations with parents and children, especially if used together.
“Effective parent communication is critical in myopia management. Using these high-value insights and tools provided by these human behavior experts will enhance ECPs’ engagement with patients and their parents, ultimately driving practice success.“
–Dr. Chandra Mickles, North America Professional Education Lead Myopia at Johnson & Johnson Vision
Uncovering Parents’ Values and Motivation for their Children
The first key element that would be beneficial to integrate into the conversations with parents is asking them about the values and motivations (what matters most to them) they hold for their children. By values, we are referring to an individual’s deepest desire for how they want to act as a person regularly — not only the goals they want to achieve.3 For example, connection and being fully present for your family is a value. A goal that you might have to live into that value would be to increase your exercise time, so you’re physically fit enough to be with them for the yearly family hiking trip.4
Knowing parents’ values for their children provides you with valuable information about what motivates them, which in turn can inform which behaviors they are likely to engage in and adhere to long term. One of the most basic psychological needs is autonomy — the ability to make one’s own decisions and feel in control of one’s behavior and destiny.5 When individuals engage in a behavior consistent with their values, they are much more likely to continue to engage in this behavior.6 For example, if a child wears glasses because their new favorite actress wears them, they won’t stick with them for a long time (unless they discover a benefit for them that they were not previously aware of). On the other hand, if a child holds curiosity (e.g., trying new hobbies) as an important value and doesn’t want their eyesight to get in the way, they are much more likely to use glasses because they are internally motivated (also called autonomous motivation).
In light of this evidence, we created a conversation guide, which we call the “conversation starter,” as a tool to facilitate uncovering those values and motivations. This tool has two sections — “what” and “why.” The “what” section asks patients what is most important and includes options such as mood (eyesight no longer a source of frustration), cost (affordable treatment), and treatment flexibility (can change treatments easily if needed). At the same time, the “why” section asks why the selections in the “what” section are important. The “why” section includes options under four domains — education, relationships, health/personal growth, and leisure. This tool gives eye care professionals the necessary information to work with the parent and child on the best treatment for them — the one they are most likely to adopt.
Partnering with Parents and Children in the Decision
The other key element is to present parents with the opportunity to partner in making decisions. Individuals are more likely to stick with behaviors or treatments when it is something that they are personally choosing and endorsing.5 In the context of eye health, we are referring to collaborating with parents on the treatment choice that best fits their child’s lifestyle. In other words, combining your expertise with parent values to support them in choosing the treatment that aligns with your expert recommendation and what’s most important to them. Encouraging the parent to make the final choice supports autonomous motivation. Involving children who are cognitively ready to understand the choices will support their autonomous motivation as well. This led to creating the Lifestyle Chart to use in conjunction with the information obtained in the conversation starter. The Lifestyle Chart makes it easy for eye care professionals and parents to see which treatment option best fits the child based on their personal values.
The Johnson & Johnson Vision Lifestyle Chart
Putting it Together
Supporting autonomous motivation is a great way to connect with the parent and child while increasing the chances for treatment adherence. In fact, autonomous motivation has been associated with improved health care behaviors.7 And this is where your conversations with parents come in! Start by identifying their values/motivations and feed this information into the Lifestyle Chart to support parents in making decisions that are consistent with and connected to the values and motivations they hold for their child.
For example, if you know what matters most (e.g., regularly playing soccer) and why (e.g., the parent values fitness for their child), you can use that information when providing treatment choices (e.g., glasses may not be the best choice for soccer). Doing this will increase the likelihood of treatment adherence. In addition, they will feel heard, their treatment is personalized, and they will likely trust you more.8
This article is sponsored by Johnson & Johnson Vision. At Johnson & Johnson, we believe in leveraging scientific evidence to improve communication with patients, with the ultimate goal of improving patients’ health.
Sophy Perdomo, PhD, Scientist 3 — Research and Development, Acro Services Corporation, provides services for Johnson & Johnson Health and Wellness Solutions.
Nicole Brainard, PhD, MPH, is a trained behavioral scientist whose career centers around the application of behavior change techniques to foster adoption of desired health behaviors, leading to improvements in overall health and wellbeing. In her current role, Dr. Brainard manages the development and implementation of behavior change interventions for internal and external partners. She completed her doctoral degree at the University of Texas School of Public Health, and holds a master’s in public health from Boston University, and a bachelor’s degree in psychology from the University of South Florida. Dr. Brainard currently serves as the Senior Manager, Behavioral Science for Johnson & Johnson Health and Wellness Solutions.
1 Riedl, D., & Schüßler, G. (2017). The influence of doctor-patient communication on health outcomes: a systematic review. Zeitschrift für Psychosomatische Medizin und Psychotherapie, 63(2), 131-150.
2 Jones, L., Drobe, B., González-Méijome, J. M., Gray, L., Kratzer, T., Newman, S., & Resnikoff, S. (2019). IMI–industry guidelines and ethical considerations for myopia control report. Investigative ophthalmology & visual science, 60(3), M161-M183.
3 Russ Harris. The Difference Between a Goals and Values Focused Life. http://thehappinesstrap.com/elementor-1628/. July 2019.
4 Russ Harris. A Quick Look at Your Values. https://www.actmindfully.com.au/wp-content/uploads/2019/07/Values_Checklist_-_Russ_Harris.pdf
5 Deci, E. & Ryan, R. (Eds.). (2002). Handbook of Self-Determination Research. Rochester, NY: The University of Rochester Press
7 Ntoumanis, N., Ng, J. Y., Prestwich, A., Quested, E., Hancox, J. E., Thøgersen-Ntoumani, C., & Williams, G. C. (2021). A meta-analysis of self-determination theory-informed intervention studies in the health domain: effects on motivation, health behavior, physical, and psychological health. Health psychology review, 15(2), 214-244.
8 Ward, P. (2018). Trust and communication in a doctor-patient relationship: a literature review. Arch Med, 3(3), 36.