PURPOSE Puerto Ricans have higher lifetime and current asthma prevalence than other racial and ethnic groups in the United States. A great many Hispanics use ethnomedical therapies for asthma. This study elicited participant knowledge of ethnomedical therapies, developed a typology of the therapies, and considered whether some types are used or deemed effi cacious based, in part, on information source.METHODS Eligible participants were randomly selected from the medical records of an inner-city primary care clinic serving a predominantly Hispanic community in Buffalo, New York. Thirty adult Puerto Ricans who had asthma or were caregivers of children with asthma were interviewed in person using a semistructured instrument. Qualitative data analysis followed a content-driven immersion-crystallization approach. Outcome measures were ethnomedical treatments for asthma known to participants, whether these treatments were used or perceived effective, and the participant's information source about the treatment.
RESULTSParticipants identifi ed 75 ethnomedical treatments for asthma. Behavioral strategies were signifi cantly more likely to be used or perceived effective compared with ingested and topical remedies (P <.001). Among information sources for ingested and topical remedies, those recommended by community members were signifi cantly less likely to be used or perceived effective (P <.001) compared with other sources. CONCLUSIONS This sample of Puerto Ricans with a regular source of medical care was signifi cantly more likely to use or perceive as effective behavioral strategies compared with ingested and topical remedies. Allopathic clinicians should ask Puerto Rican patients about their use of ethnomedical therapies for asthma to better understand their health beliefs and to integrate ethnomedical therapies with allopathic medicine.Ann Fam Med 2011;9:50-56. doi:10.1370/afm.1200.
INTRODUCTIONI n general, Hispanics have worse access to care, and the health care they receive is of poorer quality than that received by non-Hispanic whites.1 Compared with other Hispanic subgroups (eg, MexicanAmericans, Cubans), Puerto Ricans have poorer self-assessed health status, more activity limitations, and more medical conditions. 2,3 This disparity exists despite their eligibility for public health care programs as US citizens. Lifetime and current asthma prevalence are higher in Puerto Rico than any other state or territory of the United States. [4][5][6] Among Hispanics in the United States, Puerto Rican children and adults have higher lifetime asthma prevalence, 6-13 current asthma prevalence, [6][7][8][13][14][15][16]
E T HNO MEDIC A L T R E AT MEN T S F OR A S T HM AAmericans, Dominicans, Cubans). One study found Puerto Ricans have higher current asthma prevalence than Dominicans and other Hispanic subgroups, even when they have the same living environment and a similar socioeconomic status. 18 The reasons for this disparity are not known. In Buffalo, New York, where this study was conducted, Hispanics, most of w...