Racial/ethnic differences in pediatric asthma management: the importance of asthma knowledge, symptom assessment, and family-provider collaboration.
Racial/ethnic differences in pediatric asthma management: the importance of asthma knowledge, symptom assessment, and family-provider collaboration.
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DOI：
10.1080/02770903.2020.1784191
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发表时间：
2021-10
期刊：
影响因子：
--
通讯作者：
McQuaid EL
中科院分区：
文献类型：
--
作者：
Tackett AP;Farrow M;Kopel SJ;Coutinho MT;Koinis-Mitchell D;McQuaid EL
哮喘不成比例地影响来自边缘化少数群体背景的青年。核心哮喘管理（哮喘管理和药物治疗信念）方面进行了检查，在一个队列的不同家庭。护理人员-青年二人组（N= 92;法师= 13.8岁;非西班牙裔/拉丁裔白色（NLW）= 40%;黑人/非洲裔美国人= 25%;西班牙裔/拉丁裔= 35%）完成了药物信念问卷（药物必要性，药物问题）和半结构化访谈（家庭哮喘管理系统量表（FAMSS））。使用FAMSS子量表（哮喘知识、症状评估、家庭对症状的反应、儿童对症状的反应、环境控制、药物依从性、家庭-提供者协作和平衡整合）进行分析。相对于NLW（22%）和黑人/非洲裔美国人（39%）家庭，更多的西班牙裔/拉丁裔家庭处于或低于贫困线（75%）（p < .001）。相对于黑人/非裔美国人家庭，NLW的依从性（p <.01）、知识（p< .001）和症状评估（p< .01）更高。NLW（p= 0.01）和西班牙裔/拉丁裔家庭（p= 0.05）之间的合作更高。效应量中等（η2= 0.10 - 0.12）。父母的种族/民族之间的关系调节依从性和父母认为药物治疗的关注和必要性NLW和西班牙裔/拉丁裔家庭。然而，随着药物问题的增加，药物依从性下降，只有NLW和西班牙裔/拉丁裔家庭。在这个样本中，种族/民族差异出现了哮喘管理的元素。在黑人/非洲裔美国人家庭中，基于访谈的哮喘管理评级显示哮喘知识较低，家庭提供者合作水平较低，药物依从性较低。药物问题和依从性之间的关系似乎因种族而异。未来的研究需要阐明影响家庭提供者关系和健康相关行为的文化因素，如药物使用/依从性。
Asthma disproportionately impacts youth from marginalized minority backgrounds. Aspects of core asthma management (asthma management and medication beliefs) were examined among a cohort of diverse families. Caregiver-youth dyads (N= 92; Mage= 13.8 years; non-Hispanic/Latinx White (NLW) = 40%; Black/African-American = 25%; Hispanic/Latinx= 35%) completed a medication beliefs questionnaire (Medication Necessity, Medication Concerns) and a semi-structured interview (Family Asthma Management System Scale (FAMSS)). FAMSS subscales (Asthma Knowledge, Symptom Assessment, Family Response to Symptoms, Child Response to Symptoms, Environmental Control, Medication Adherence, Family-Provider Collaboration, and Balanced Integration) were used for analyses. More Hispanic/Latinx families were at or below the poverty line (75%) relative to NLW (22%) and Black/African-American (39%) families (p < .001). Adherence (p< .01), Knowledge (p< .001), and Symptom Assessment (p< .01) were higher for NLW relative to Black/African-American families. Collaboration was higher among NLW (p= .01) and Hispanic/Latinx families (p= .05). Effect sizes were moderate (η2= .10 – .12). Parental race/ethnicity moderated the relationship between adherence and parental perceived medication concern and necessity for NLW and Hispanic/Latinx families. As medication concerns increased, medication adherence decreased, however, only for NLW and Hispanic/Latinx families. In this sample, racial/ethnic differences emerged for elements of asthma management. Interview-based ratings of asthma management among Black/African-American families depicted lower asthma knowledge, lower levels of family-provider collaboration, and lower medication adherence. The relationship between medication concerns and adherence appeared to differ by ethnic group. Future research is needed to elucidate cultural factors that influence family-provider relationships and health-related behaviors, like medication use/adherence.
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