{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T14:39:38Z","timestamp":1787582378220,"version":"build-2736575974"},"reference-count":73,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T00:00:00Z","timestamp":1754611200000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Medication adherence is essential in managing cystic fibrosis (CF). The role of socioeconomic factors for medication adherence in people with CF is poorly understood, and their differential impact across the life course is underexplored. This study investigates associations between measures of socioeconomic status (SES)\u2014educational attainment, household income, and health insurance type\u2014and adherence to CF medications across age groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a cross\u2010sectional analysis of data collected during the validation of the Daily Care Check\u2010In, a measure of adherence barriers in people with CF. Adherence was measured as a composite medication possession ratio (cMPR) averaged across five CF\u2010specific medications, with data collected from pharmacy records. Sociodemographic and clinical data were collected through self\u2010report and medical record review.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 405 participants completed the study, with an overall cMPR of 45.6%, lowest (38.5%) among young adults (aged 18\u221226 years) and highest (53.0%) among adolescents (aged 13\u221217 years). Lower household income and lack of college degree were associated with lower cMPR, more interference from adherence barriers, and decreased self\u2010efficacy, as well as with increased depressive and anxiety symptoms. Similar associations, but less consistent, were observed for public health insurance. When stratified by age, associations between SES measures and adherence were most evident in adolescents, followed by adults, but absent in young adults, bringing into focus challenges with measuring SES in the 18\u221225 years age group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Lower SES is associated with worse medication adherence, more interference from adherence barriers, and lower self\u2010efficacy. Associations vary by SES measure and age group, calling for a nuanced approach to adherence interventions in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ppul.71230","type":"journal-article","created":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T11:46:37Z","timestamp":1754653597000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Associations Between Socioeconomic Status and Adherence to Medications in People With Cystic Fibrosis"],"prefix":"10.1002","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4052-1524","authenticated-orcid":false,"given":"Gabriela R.","family":"Oates","sequence":"first","affiliation":[{"name":"Pulmonary, Allergy and Critical Care Medicine University of Alabama at Birmingham Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin A.","family":"Riekert","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Pulmonary and Critical Care Medicine Johns Hopkins University Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3855-770X","authenticated-orcid":false,"given":"Christine","family":"Ford","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Pulmonary and Critical Care Medicine Johns Hopkins University Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberly M.","family":"Dickinson","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pulmonary, Allergy\/Immunology, Cystic Fibrosis and Sleep Emory University Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4991-5167","authenticated-orcid":false,"given":"Jennifer L.","family":"Butcher","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Psychology, Mott Children's Hospital Michigan Medicine Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Naranjo","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Endocrinology Stanford University Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4968-1460","authenticated-orcid":false,"given":"Hanna","family":"Phan","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, College of Pharmacy University of Michigan Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cori","family":"Daines","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pulmonary and Sleep Medicine University of Arizona Tucson Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Grabowski","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Medicine Boston Children's Hospital Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael S.","family":"Schechter","sequence":"additional","affiliation":[{"name":"Children's Hospital of Richmond at Virginia Commonwealth University Richmond Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Barriers Study Team","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,8,8]]},"reference":[{"issue":"4","key":"e_1_2_9_2_1","doi-asserted-by":"crossref","first-page":"522","DOI":"10.4187\/respcare.09540522","article-title":"Cystic Fibrosis Pulmonary Guidelines: Airway Clearance Therapies","volume":"54","author":"Flume P. 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