Graduate School of Nursing Dissertations



Publication Date


Document Type

Dissertation, Doctoral


Graduate School of Nursing

Dissertation Committee Chair

Nancy Morris, PhD


Self-management, Cerebral Palsy, Transition Readiness, Health Literacy, Transtheoretical Model

Subject Categories

Behavior and Behavior Mechanisms | Health Psychology | Information Literacy | Nervous System Diseases | Nursing | Pediatric Nursing


Purpose: Assess the effectiveness of an online intervention to encourage self-management in adolescents with cerebral palsy (CP).

Specific Aims: (a) assess effectiveness of an online intervention to promote readiness for self-management in adolescents with CP, (b) describe health literacy and associations with readiness to assume self-management, and (c) evaluate adolescents’ exposure to the online intervention.

Hypotheses: (a) intervention subjects would demonstrate improvement in self-management, and (b) subjects with higher health literacy would demonstrate higher self-management capabilities.

Framework: Transtheoretical Model of Health Behavior Change

Design: Randomized control trial, performed in a multidisciplinary CP clinic at a university based children’s hospital. Instruments used: (a) Transition Readiness Assessment Questionnaire (TRAQ) and (b) the Health Literacy Skills Instrument-SF (HLSI). Due to low engagement, the study terminated early. Intervention subjects were interviewed to assess their limited engagement.

Results: Seventy-five percent of subjects demonstrated inadequate HL. Mean baseline TRAQ score (n=24) was 2.71 (SE = .24). Positive associations were found between TRAQ and age (.47, p = .00) and TRAQ and HL (.48, p = .00).

Conclusion: Failure to engage with the intervention appeared to be related to: (a) low HL, (b) low TRAQ scores (indicating subjects in contemplation stage) (c) inconsistency between subjects’ preference for learning and delivery of information, and (d) low motivation for self directed learning. Online interventions should be easy to use and include learning preferences. Lessons learned will inform future development of interventions for this population.



Rights and Permissions

Copyright © 2018 Thompson

Creative Commons License

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.