Difficult Family Relationships, Residential Greenspace, and Childhood Asthma
Difficult Family Relationships, Residential Greenspace, and Childhood Asthma
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DOI：
10.1542/peds.2016-3056
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发表时间：
2017-04-01
期刊：
影响因子：
8
通讯作者：
Brauer, Michael
中科院分区：
文献类型：
--
作者：
Chen, Edith;Miller, Gregory E.;Brauer, Michael
背景和目的：社会环境和物理环境越来越被认为对哮喘等儿童疾病的重要性。本研究验证了一个新的假设：生活在高的绿地地区可能有助于缓冲困难的家庭关系对哮喘儿童的影响。方法：共有150名儿童（9-17岁），医生诊断为哮喘，参加了这项研究。为了评估亲子关系中的困难，父母和孩子完成了严厉/不一致的养育和父母的敌意的措施。住宅绿地计算使用卫星派生的归一化差异植被指数与住宅地址周围250米的缓冲区。结果包括临床和生物学指标：哮喘控制和功能限制，以及气道炎症（呼出气一氧化氮浓度分数）和糖皮质激素受体在辅助性T细胞中的表达。在控制了潜在的混杂变量（包括家庭收入、儿童人口统计学和儿童医疗变量）后，几乎没有发现主要影响。在哮喘控制（P = 0.02）、哮喘功能受限（P = 0.04）、气道炎症（P = 0.007）和辅助性T细胞中糖皮质激素受体丰度（P = 0.05）方面，发现了住宅绿地和困难家庭关系之间的相互作用。这些相互作用都是在一个方向，这样的亲子关系的质量得到改善，绿地变得更加强烈地与更好的哮喘outcomes.CONCLUSIONS：这些研究结果表明协同效应的积极的环境中的物理和社会领域。当哮喘儿童生活在高绿地区域并拥有积极的家庭关系时，他们似乎受益最大。
BACKGROUND AND OBJECTIVES: Both the social environment and the physical environment are increasingly recognized as important to childhood diseases such as asthma. This study tested a novel hypothesis: that living in areas high in greenspace may help buffer the effects of difficult family relationships for children with asthma.METHODS: A total of 150 children (ages 9-17), physician-diagnosed with asthma, participated in this study. To assess difficulties in parent-child relationships, parents and children completed measures of harsh/inconsistent parenting and parental hostility. Residential greenspace was calculated by using satellite-derived Normalized Difference Vegetation Index with a buffer of 250 m around the residential address. Outcomes included both clinical and biological measures: asthma control and functional limitations, as well as airway inflammation (fractional concentration of exhaled nitric oxide) and glucocorticoid receptor expression in T-helper cells.RESULTS: After controlling for potential confounding variables, including family income, child demographics, and child medical variables, few main effects were found. However, interactions between residential greenspace and difficult family relationships were found for asthma control (P =.02), asthma functional limitations (P =.04), airway inflammation (P =.007), and the abundance of glucocorticoid receptor in T-helper cells (P =.05). These interactions were all in a direction such that as the quality of parent-child relationships improved, greenspace became more strongly associated with better asthma outcomes.CONCLUSIONS: These findings suggest synergistic effects of positive environments across the physical and social domains. Children with asthma appear to benefit the most when they both live in high greenspace areas and have positive family relationships.