Caregiver stress among inner-city school children with asthma

Kopel, Lianne S.; Petty, Carter R.; Gaffin, Jonathan M.; Sheehan, William J.; Baxi, Sachin N.; Kanchongkittiphon, Watcharoot; Fu, Chunxia; Gold, Diane R.; Phipatanakul, Wanda

doi:10.1016/j.jaip.2017.02.026

Cited by 17 publications

(12 citation statements)

References 10 publications

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“…There are a number of psychological factors associated with economically disadvantaged neighborhoods that have been linked to higher rates of asthma incidence and worsening asthma morbidity in these communities (Table I) (12–14). These factors include but are not limited to stress, high rates of unemployment, increased crime and violence rates, substandard housing, and lack of social support.…”

Section: Racial/ethnic and Socioeconomic Disparities In Childhood Astmentioning

confidence: 99%

“…Kopel and colleagues illustrated that the primary caregivers’ perception of neighborhood safety is associated with childhood asthma morbidity among inner-city schoolchildren with asthma (13). They also demonstrated that inner-city caregiver stress is related to worsened asthma morbidity among children (14). Intervention studies to improve asthma outcomes in these vulnerable populations are needed.…”

Section: Racial/ethnic and Socioeconomic Disparities In Childhood Astmentioning

confidence: 99%

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Taming Asthma in School-Aged Children: A Comprehensive Review

Naja

Permaul

Phipatanakul

2018

The Journal of Allergy and Clinical Immunology: In Practice

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Asthma is the most common chronic disease of childhood and the leading cause of childhood morbidity as measured by school absences, emergency department visits, and hospitalizations. Multiple factors play a role in the development, treatment and prevention of childhood asthma including racial/ethnic and socioeconomic disparities, both the home and school environments, and medication use. The goals of this review are to summarize these aspects of asthma in school-aged children and to present an updated review of medications as it relates to treatment strategies that will help in the care of these children. We conclude that phenotypic heterogeneity and appropriate environmental assessments and interventions are important considerations in the management of childhood asthma.

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Section: Racial/ethnic and Socioeconomic Disparities In Childhood Astmentioning

confidence: 99%

Section: Racial/ethnic and Socioeconomic Disparities In Childhood Astmentioning

confidence: 99%

Taming Asthma in School-Aged Children: A Comprehensive Review

Naja

Permaul

Phipatanakul

2018

The Journal of Allergy and Clinical Immunology: In Practice

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“…Studies of the impact of social determinants of health adherence alone are mixed: family socioeconomic status has not been consistently associated with medication adherence, 35 indicating that health beliefs may play a large role in all families (see Section 5.2). Poor access to transportation 36 and higher levels of caregiver stress are associated with more asthma symptom days, as well as greater reported dyspnea 37 . However, minority race has been associated with poorer medication adherence, independent of socioeconomic status 35,38–40 …”

Section: Patient and Family Level Factorsmentioning

confidence: 99%

“…Poor access to transportation 36 and higher levels of caregiver stress are associated with more asthma symptom days, as well as greater reported dyspnea. 37 However, minority race has been associated with poorer medication adherence, independent of socioeconomic status. 35,[38][39][40]…”

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confidence: 99%

They just don't take their medicines: Reframing medication adherence in asthma from frustration to opportunity

Keyser

Ramsey

Federico

2020

Pediatric Pulmonology

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Assessing and addressing suboptimal adherence to asthma medications is a key component in the treatment of all children with asthma, particularly those with difficult‐to‐treat asthma. However, parents often overreport adherence to asthma medications. Increased medication adherence could lead to improved outcomes in the form of better asthma control and decreased asthma exacerbations, as well as decreased healthcare utilization costs. Yet there are many complex factors that affect medication adherence, and barriers are often different in each family. Social determinants of health, complex healthcare relationships, and patient‐related factors may all affect medication adherence. Multicomponent patient‐centered strategies, as well as strategies that utilize technology and habit formation strategies may be helpful in improving medication adherence. Further study is needed to reliably and sustainably improve medication adherence in children with asthma across the broader population; in some populations, alternate diagnoses, adjusting therapy, and other intervention may be required to improve asthma control and health.

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“…These findings emphasize the multifaceted nature of socioeconomic status and the need for it to be captured using multiple measures. The stress of caregivers of students enrolled in the school inner-city asthma study was associated with worse asthma outcomes [26•]. Participants with caregivers with very high stress (PSS-4 > =8) had two times increased odds of haying a symptom day and 2.1 more symptom days over a 2-week period compared to participants with normal stress.…”

Section: Mechanisms Of Worse Outcomes In Disadvantaged Communitiesmentioning

confidence: 99%

Managing Asthma in Low-Income, Underrepresented Minority, and Other Disadvantaged Pediatric Populations: Closing the Gap

Louisias

Phipatanakul

2017

Curr Allergy Asthma Rep

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Purpose of Review In this article, we review current understanding of the epidemiology and etiology of disparities in asthma. We also highlight current and emerging literature on solutions to tackle disparities while underscoring gaps and pressing future directions. Recent Findings Tailored, multicomponent approaches including the home, school, and clinician-based interventions show great promise. Summary Managing asthma in disadvantaged populations can be challenging as they tend to have disproportionately worse outcomes due to a multitude of factors. However, multifaceted, innovative interventions that are sustainable and scalable are key to improving outcomes.

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Caregiver stress among inner-city school children with asthma

Cited by 17 publications

References 10 publications

Taming Asthma in School-Aged Children: A Comprehensive Review

Taming Asthma in School-Aged Children: A Comprehensive Review

They just don't take their medicines: Reframing medication adherence in asthma from frustration to opportunity

Managing Asthma in Low-Income, Underrepresented Minority, and Other Disadvantaged Pediatric Populations: Closing the Gap

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