Identifying Individual, Cultural and Asthma-Related Risk and Protective Factors Associated With Resilient Asthma Outcomes in Urban Children and Families

Koinis-Mitchell, Daphne; McQuaid, Elizabeth L.; Jandasek, Barbara; Kopel, Sheryl J.; Seifer, Ronald; Klein, Robert B.; Potter, Christina; Fritz, Gregory K.

doi:10.1093/jpepsy/jss002

Cited by 49 publications

(35 citation statements)

References 38 publications

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“…3,24 These urban risks, detailed elsewhere, 3,22 include increased poverty, which can contribute to higher levels of stress within the home, neighborhood stressors (e.g., crime), and acculturative stress and discrimination. 25 Further, urban stressors (e.g., noise, crowded housing) can affect children’s sleep environment 2 and sleep behaviors (e.g., inconsistent sleep/wake times). 26 Urban children with asthma are at greater disadvantage for poor sleep quality and shortened sleep due to combined risks related to asthma status and urban poverty.…”

Section: Introductionmentioning

confidence: 99%

Asthma-related lung function, sleep quality, and sleep duration in urban children

et al. 2017

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Objectives Examine 1) the extent to which changes in objectively measured asthma-related lung function (FEV1 % predicted) within a sleep period are associated with sleep quality and sleep duration during that sleep period, in a group of urban children with persistent asthma; and 2) associations between morning and evening asthma-related lung function and sleep quality and duration on the adjacent night, and 3) whether these associations differ by ethnic group. Design Cross-sectional, multi-method approach. Children completed a clinic assessment of asthma and allergy status and used home-based objective measurements of asthma-related lung function and sleep. Setting Children and their caregivers participated in a clinic assessment at an asthma and allergy clinic and completed additional assessments at home. Participants Two hundred and sixteen African American, Latino, and non-Latino white urban children, ages 7–9 years, and their primary caregivers. Measurements Participants took part in a clinic assessment of asthma and allergy status, completed interview-based questionnaires including a diary to track asthma symptoms and sleep patterns, and used actigraphy and home-based spirometry daily across a 4-week period to assess sleep and lung function. Results and Conclusions Results from analyses using structural equation modeling revealed an association between worsening FEV1 and poor sleep quality in the full sample, as well as better asthma-related lung function at night and more optimal sleep efficiency that night. Ethnic group differences emerged in the association with morning or nighttime lung function measurements and sleep quality. Urban minority children with asthma may be at heightened risk for poorer quality sleep. Timing of lung function worsening may be important when considering when and how to improve both asthma health outcomes and sleep quality within specific groups.

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Section: Introductionmentioning

confidence: 99%

Asthma-related lung function, sleep quality, and sleep duration in urban children

et al. 2017

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“…This study also associated a higher number of children living in the home with fewer prescriptions filled and an increased likelihood of asthma exacerbations [4]. While many have examined the importance of the urban context, including poverty and race, on child asthma [5-7], no prior study has focused on caregiver marital status, specifically single parent households and asthma morbidity, particularly among children ill enough to be hospitalized.…”

Section: Introductionmentioning

confidence: 99%

Single parent households and increased child asthma morbidity

et al. 2014

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Objectives To characterize whether single parent households are associated with pediatric asthma-related repeat healthcare utilization and to examine family-level psychosocial variables that may explain this relationship. Methods We analyzed a prospective cohort of 526 children aged 1–16 years hospitalized for asthma or bronchodilator-responsive wheezing whose caregivers self-reported their marital status. Those reporting being “single” were considered the at-risk category. The outcome was repeat asthma-related utilization (emergency room (ER) revisit or hospital readmission) within 12 months. We assessed, a priori, four psychosocial variables (household income, caregiver risk of psychological distress, ratio of in-home children to adults, and regular attendance at childcare or a secondary home). Results Among all children enrolled in the cohort, 40% returned to the ER or hospital for asthma within 12 months. Of all caregivers, 59% self-identified as single. Single status was significantly associated with each psychosocial variable. Children in households with lower incomes and higher ratios of children to adults were both more likely to return to the ER or hospital than children with higher incomes and lower ratios, respectively (each p<0.05). Patients in single parent households were significantly more likely to reutilize than those in married parent households (OR 1.44, 95% CI 1.00–2.07, p<0.05). When adjusted for income, the relationship between single parent households and reutilization became non-significant. Conclusions Children admitted for asthma from single parent households were more likely to have asthma-related reutilization within 12 months than children from homes with married parents. This was driven, in large part, by underlying differences in household income.

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“…In these cultures, the family is the primary source of social relationships and assistance crucial to one's sense of identity and self-worth (Desai et al, 2016;Jones et al, 2013). Family support (Scheckner, Arcoleo, & Feldman, 2015) and higher levels of family connectedness and stronger ethnic identity appear to be protective factors against asthma-related limitations (Koinis-Mitchell et al, 2012). Family group orientation is customary in Asian cultures (Purnell, 2014) as well as indigenous peoples such as Native Americans (McCubbin, Thompson, Thompson, McCubbin, & Kaston, 1993) and Aboriginal people of Canada (Castleden et al, 2016).…”

Section: Discussionmentioning

confidence: 99%

Mālama nā makua i nā keiki me ka hānō: Native Hawaiian parents caring for their children with asthma

Kealoha¹,

Kataoka‐Yahiro²

2017

Asian/Pacific Island Nursing Journal

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Native Hawaiian children have the highest prevalence rate of asthma among all ethnicities in the State of Hawai'i. Literature is limited regarding native Hawaiian parents' perception and experience caring for their children with asthma. The purpose of this study is to explore contemporary native Hawaiian parents' perspective and experience of caring for their children with asthma in the context of uncertainty. We applied a descriptive qualitative approach by means of directed content analysis using focus groups. Directed content analysis applied Mishel's Uncertainty in Illness Theory to guide data collection, organization, and analysis. We found that parents' personal stories about their children to be rich and enlightening. Findings verified that native Hawaiian parents experience uncertainty regarding asthma care as commonly described in the literature. Contextual influences including indigenous worldview and cultural values affected native Hawaiian parents' perceptions and experiences with conventional asthma care. Unique findings involved the etiology of asthma, features of social support ('ohana), and differentiation between Western medicine and traditional healing practices. As nurses focus on supporting the family's cultural values and preferences related to asthma care and alternative remedies, native Hawaiian parents' care of their children with asthma will be strengthened.

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Identifying Individual, Cultural and Asthma-Related Risk and Protective Factors Associated With Resilient Asthma Outcomes in Urban Children and Families

Cited by 49 publications

References 38 publications

Asthma-related lung function, sleep quality, and sleep duration in urban children

Asthma-related lung function, sleep quality, and sleep duration in urban children

Single parent households and increased child asthma morbidity

Mālama nā makua i nā keiki me ka hānō: Native Hawaiian parents caring for their children with asthma

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