Parental Perspectives of Barriers to Physical Activity in Urban Schoolchildren With Asthma

Kornblit, Amy; Cain, Agnieszka; Bauman, Laurie J.; Brown, Nicole M.; Reznik, Marina

doi:10.1016/j.acap.2017.12.011

Cited by 25 publications

(29 citation statements)

References 32 publications

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“…The outcome of this misinterpretation may be that children restrict their activity levels and subsequently have lower fitness ability and develop exercise avoidance behaviours (18,19). As has been previously documented in the literature, participants in this study suggested that restricting exercise may also develop from fear of exercise-induced asthma attacks (8). Research has shown that parental anxiety can lead to children developing avoidance behaviours in asthma-threat scenarios (20).…”

Section: Discussionsupporting

confidence: 59%

“…The US National Asthma Education and Prevention Program recommends weight management to improve overall health and asthma control in both adults and children (7). Yet most paediatric weight management programmes are not tailored to the unique needs of living with asthma, such as addressing parental anxieties that arise from breathlessness when exercising and the child's perceptions of exercise parameters (8,9). So far, the limited weight management programmes designed specifically for children living with asthma have shown promising results in improving asthma control and reducing weight (10).…”

Section: Introductionmentioning

confidence: 99%

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Weight-management in children living with asthma: a qualitative study of the experiences of paediatric healthcare professionals

et al. 2018

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Objective: Weight loss has been found to improve the symptoms of asthma in children who are overweight. However, many paediatric weight management programmes do not address the challenges associated with living with asthma. The aim of this study was to explore the views and experiences of paediatric healthcare professionals concerning weight management advice and support offered to families of children living with asthma. Methods: In-depth individual interviews with 10 healthcare professionals who work with a paediatric asthma population (n= 4 Respiratory Consultants, 3 Respiratory Nurses, 3 General Paediatricians). Data were analysed using a Framework approach. Results: Healthcare professionals highlighted that families' perceptions of weight, their approach to physical activity and nutrition, the family's social context and perceptions of asthma and asthma treatment all influence weight management in children living with asthma. Initiating weight management conversations and referring to weight management support were perceived as challenging. It was thought that tailoring weight management to the needs of children living with asthma and locating support within the community were important to the success of a family-centred intervention. Conclusion: The results highlight the added complexity of responding to excessive weight in a paediatric population with asthma. Training and referral guidance for healthcare professionals may help overcome weight management support challenges. Addressing family beliefs about the factors influencing paediatric asthma and exploring families' motivations for behaviour change may enhance engagement with weight management.

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Section: Discussionsupporting

confidence: 59%

Section: Introductionmentioning

confidence: 99%

Weight-management in children living with asthma: a qualitative study of the experiences of paediatric healthcare professionals

et al. 2018

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“…Similarly, a study of elementary school teachers demonstrated few were aware that students with asthma need not avoid exercise [76]. Part of parental concern appears to be driven by worry regarding lack of symptom perception in children and lack of trust in school asthma management [77]. Other barriers have also been identified that prevent this group of patients in engaging with physical activity: fear of exacerbating symptoms, with patients with more severe disease more likely to view exercise as detrimental [78], and children's poor adherence to treatment also identified as barriers [77].…”

Section: Barriers To Exercise In Children With Asthmamentioning

confidence: 99%

Defining a role for exercise training in the management of asthma

2020

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The prevalence of asthma remains high worldwide, with increasing awareness of the morbidity and mortality from asthma in low-income countries. In the UK, despite the development of biological treatments, many patients remain suboptimally controlled, and mortality rates have been static for decades. Therefore, new approaches are needed to treat asthma that are scalable at minimal cost. Exercise immunology is an expanding field, and there is growing evidence that exercise can modulate inflammatory and immune processes in asthma. Whilst exercise is encouraged in current treatment guidelines, there are no specific recommendations as to the intensity, frequency or duration of exercise exposure. Despite national and international guidance to increase exercise, patients with asthma are less likely to engage in physical activity. This review explores the disease modifying benefit of exercise in asthma. We also review the domains in which exercise exerts positive clinical effects in asthma, including the effects of exercise on symptom scores, quality of life, psychosocial health, and in the obese asthma phenotype. Finally, we review the barriers to exercise in asthma, given the benefits it confers. A better understanding of the mechanisms through which exercise exerts its positive effects in asthma may provide more accurate prescription of exercise training programmes as part of broader asthma management, with the potential of identification of new drug targets.

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“…Parents of children with asthma have identified barriers unique to the child's medical condition. Challenges and lack of trust for asthma management, exacerbation of the condition due to a lack of the child's awareness of symptom onset, and nonadherence to required treatment or medications were of significant concern (12). It has also been reported that parents and health care providers have different perceptions regarding the physical activity restrictions appropriate for children with complex cardiac conditions (13).…”

Section: Abstract: Cardiology; Habitual Physical Activity; Parent Permentioning

confidence: 99%

Understanding parent perceptions of healthy physical activity for their child with a chronic medical condition: A cross-sectional study

McMullen

McCrindle

Dell

et al. 2018

Paediatrics &Amp; Child Health

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Objective: We sought to determine the prevalence of, and identify factors associated with, parent questions about physical activity for their child with a chronic cardiac, respiratory, or rheumatologic condition. Methods: This cross-sectional study of 56 children (32 [57%] female), 3 to 18 years of age, with chronic cardiac (n=21), respiratory (n=18), or rheumatologic (n=17) conditions involved a parent questionnaire about their child's physical activity participation and measurement of the child's activity with an omni-directional accelerometer for 1 week. Results: Parents of 20 (36%) children had at least one question about their child's physical activity participation, and the prevalence of questions did not vary by age (Wald chi square = 0.77, P=0.38), gender (Wald chi square = 0.11, P=0.74), or clinic (Wald chi square = 1.77, P=0.41). Parent questions were associated (P = 0.04) with lower levels of activity for boys (95% confidence interval [CI] for estimated marginal means: With questions: 197, 395; Without questions: 346, 500) and higher levels of activity for girls (95% CI for estimated marginal means: With questions: 268, 448; Without questions: 239, 369). A multivariable logistic regression model found that parents with questions had higher odds of having a child who was less well (odds ratio [OR]=19.9 for unwell, OR=5.6 for generally well with some symptoms versus well and asymptomatic) and had a history of cardiac arrhythmia (OR=7.6). Conclusions: Over one-third of parents reported having questions about physical activity for their child with a chronic medical condition, suggesting substantial uncertainty even among children reported as active. Presence of parent uncertainty is associated with parent reports of the child being unwell or a history of cardiac arrhythmia. By asking parents if they have questions about their child's

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Parental Perspectives of Barriers to Physical Activity in Urban Schoolchildren With Asthma

Abstract: A complex, multilevel set of barriers to PA exist in children with asthma. Addressing these barriers by involving stakeholders at the family, school, and community levels may improve PA levels in children with asthma.

Cited by 25 publications

References 32 publications

Weight-management in children living with asthma: a qualitative study of the experiences of paediatric healthcare professionals

Weight-management in children living with asthma: a qualitative study of the experiences of paediatric healthcare professionals

Defining a role for exercise training in the management of asthma

Understanding parent perceptions of healthy physical activity for their child with a chronic medical condition: A cross-sectional study

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