Barriers to Asthma Management Among Urban Families: Caregiver and Child Perspectives

Laster, Nastassia; Holsey, Chanda Nicole; Shendell, Derek G.; McCarty, Frances; Celano, Marianne

doi:10.1080/02770900903082571

Cited by 86 publications

(81 citation statements)

References 18 publications

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“…The disparity between the level of asthma severity perceived by parents and the actual reported symptoms supports previously reported work in this field [11,13,21]. These data, taken in conjunction with previous reports, suggest that parents seem to maintain a belief that even mild asthma will remain symptomatic despite treatment with ICS, placing an important obstacle in the path of guideline-defined control for children [22,23]. (14) 722 (86) 82 (10) 762 (90) 844 (100) Data are presented as n (%).…”

Section: Discussionsupporting

confidence: 77%

Parent misperception of control in childhood/adolescent asthma: the Room to Breathe survey

Carroll

Wildhaber²,

Brand³

2011

Eur Respir J

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Section: Discussionsupporting

confidence: 77%

Parent misperception of control in childhood/adolescent asthma: the Room to Breathe survey

Carroll

Wildhaber²,

Brand³

2011

Eur Respir J

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“…A qualitative study conducted with families in urban, low-income communities found that parents of children with asthma frequently cited confusion regarding health care plans and medications covered by their plan. 34 In addition, in a study examining adult patients' knowledge of their copayments, Benedetti et al found that patients have limited knowledge of Chi-square tests were performed on clinical variables of interest to identify differences between the groups NS not significant *pG0.05, **pG0.01, ***pG0.001, as levels of significance reported copayments and make decisions about how and when to seek care in response to perceived costs with very limited discussion with their health care providers. 35 Parents who perceive financial burden with their child's asthma management may not have had opportunities to address these concerns and alternative solutions with their providers.…”

Section: Discussionmentioning

confidence: 99%

Perceived Parent Financial Burden and Asthma Outcomes in Low-Income, Urban Children

2012

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The purpose of this study was to describe the demographic characteristics of low-income parents who perceive financial burden in managing their child's asthma and related associations with their children's asthma outcomes and clinical characteristics. We hypothesized that (1) identifiable differences between parents who do and do not report burden; (2) regardless of access to care, asthma outcomes would be worse for children whose parents perceive financial burden in obtaining care for their child's condition. Baseline data from a randomized trial evaluating the effect of a school-based asthma intervention were analyzed for this research. Eight hundred thirty-five parents were interviewed by telephone regarding their child's asthma management. Associations between demographic and clinical factors and perception of financial burden were examined using bivariate analysis. Multivariate regression analyses were used to examine associations between perceptions of financial burden and asthma outcomes, including emergency department visits, hospitalizations, and missed school days. Perceived financial burden was evident in 10 % (n079) of parents. Female heads of household (χ 2 (3)07.41; pG0.05), those at the lowest income levels (χ 2 (3)012.14; pG0.01), and those whose child's asthma was poorly controlled (χ 2 (2)049.42; pG0.001) were most likely to perceive financial burden. In models controlling for level of asthma control, income, and having a usual source of asthma care, parents who perceived financial burden were more likely to have children who had at least one emergency department visit (OR01.95; 95 % CI01.15 to 3.29), hospitalization (OR03.99; 95 % CI02.03 to 7.82), or missed school days due to asthma (OR03.26; 95 % CI01.60 to 6.67) in the previous year. Our results supported our hypotheses. Among low-income parents of children with asthma, the majority do not perceive financial burden to obtaining care. However, among parents that do perceive burden, urgent care use and missed school days due to asthma for their child were significantly higher, regardless of family income and having a usual source of asthma care. Mothers and grandmothers heading families and those caring for children with uncontrolled asthma were most likely to report burden. These findings have implications for clinical practice in that health care providers may be able to take simple actions to determine patients' financial-related perceptions, correct misconceptions, and help patients consider their full range of options to manage their child's asthma.

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“…Shalowitz (75) showed that in urban, low-income areas, mothers of children with asthma were more likely to suffer from depression and report more "life stressors" than were those in families where asthma was not present. Studies have illustrated that lower levels of quality of life and day-to-day disruptions are evident in low-income families with asthma (56).…”

Section: Prevalence and Burden Of Asthmamentioning

confidence: 99%

Community-Based Approaches to Controlling Childhood Asthma

Clark

2012

Annu. Rev. Public Health

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The prevalence and burden of childhood asthma remain high and are increasing. Asthma hot spot neighborhoods around the country face particular challenges in controlling the effects of the condition. Increasing attention is being paid to developing interventions that recognize the child and family as the primary managers of disease and to introducing assistance that reaches beyond the clinical care setting into the places where families live and work. A range of types of community-focused interventions has been assessed in the past decade in schools, homes, and community health clinics, and programs using electronic media and phone links have been evaluated. Stronger evidence for all these approaches is needed. However, school-based programs and community coalitions designed to bring about policy and systems changes show particular promise for achieving sustainable improvements in asthma control. Research is needed that emphasizes comparisons among proven asthma control interventions, translation of effective approaches to new settings and communities, and institutionalization of effective strategies.

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Barriers to Asthma Management Among Urban Families: Caregiver and Child Perspectives

Abstract: Families in urban, low-income communities require asthma management interventions tailored to their specific characteristics, barriers, and challenges. Our findings can be used to inform and enhance asthma management interventions for urban families with children with asthma.

Cited by 86 publications

References 18 publications

Parent misperception of control in childhood/adolescent asthma: the Room to Breathe survey

Parent misperception of control in childhood/adolescent asthma: the Room to Breathe survey

Perceived Parent Financial Burden and Asthma Outcomes in Low-Income, Urban Children

Community-Based Approaches to Controlling Childhood Asthma

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