Asthma Communication & Adherence In Inner-City Children

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DESCRIPTION (provided by applicant): Asthma-related morbidity and mortality are disproportionately high among inner-city African-American children. African-American and poor children have higher rates of emergency department use, hospitalization, decreased quality of life, and increased risk of fatal asthma. Research has shown that African-American children are less likely to receive guideline-base care, which may account for their increased morbidity. Inadequate family-physician communication about asthma, including symptom severity, the prescribed regimen, other medications the child is using and psychosocial barriers to illness management may contribute to poorer asthma management. Research with adults has linked physician patient communication to a variety of health outcomes, including symptom resolution, functional status, physiologic measures and pain control, and recall and understanding of medical information. Furthermore, research with adults suggests that improved communication results in better patient adherence. However, this relationship has not been corroborated using objective measures of medication adherence. Moreover, little research has been conducted examining the relationship between family-physician communication and children's health outcomes, particularly in inner-city children with asthma. One intervention study that focused on improving physicians' asthma communication skills found that improved communication resulted in physicians increased adherence to guideline-based asthma management and had a moderate impact on the child's health care utilization. The researchers did not assess the impact of improved communication on family management of asthma. Thus, the purpose of this application is to develop a pediatric asthma communication tool (PACT) and conduct a pilot study of the utility of the PACT as part of a caregiver-focused communication intervention to improve family-physician communication and subsequent asthma medication adherence. (End of Abstract)