TY - JOUR
T1 - Explanatory model for asthma disparities in Latino children
T2 - Results from the Latino Childhood Asthma project
AU - Arcoleo, Kimberly
AU - Marsiglia, Flavio
AU - Serebrisky, Denise
AU - Rodriguez, Juliana
AU - McGovern, Colleen
AU - Feldman, Jonathan
N1 - Publisher Copyright:
© The Author(s) 2019. Published by Oxford University Press on behalf of the Society of Behavioral Medicine.
PY - 2020/4/1
Y1 - 2020/4/1
N2 - Background: Little research has been conducted that integrates, in one explanatory model, the multitude of factors potentially leading to disparities among Latino children. Purpose: A longitudinal, observational study tested an explanatory model for disparities in asthma control between Mexican and Puerto Rican children with persistent asthma requiring daily controller medication use. Methods: Mexican and Puerto Rican children aged 5-12 years (n = 267) and their caregivers (n = 267) were enrolled and completed interviews and child spirometry at baseline and 3, 6, 9, and 12 months postenrollment. A 12 month retrospective children's medical record review was completed. Participants were recruited from two school-based health clinics and the Breathmobile in Phoenix, AZ, and two inner-city hospital asthma clinics in the Bronx, NY. Results: Statistically significant differences in the social/ contextual predictors of asthma illness representations (IRs) were noted between Mexican and Puerto Rican caregivers. The structural equation model results revealed differences in asthma control over time by ethnicity. This model accounted for 40%-48% of the variance in asthma control test scores over 12 months. Caregivers' IRs aligned with the professional model of asthma management were associated with better children's asthma control across 1 year. These results also supported the theoretical notion that IRs change over time impacting caregivers' treatment decisions and children's asthma control. Conclusions: These findings extend a previous cross-sectional model test using a more comprehensive model and longitudinal data and highlight the importance of considering within-group differences for diagnosis and treatment of children coming from the vastly heterogeneous Latino umbrella group.
AB - Background: Little research has been conducted that integrates, in one explanatory model, the multitude of factors potentially leading to disparities among Latino children. Purpose: A longitudinal, observational study tested an explanatory model for disparities in asthma control between Mexican and Puerto Rican children with persistent asthma requiring daily controller medication use. Methods: Mexican and Puerto Rican children aged 5-12 years (n = 267) and their caregivers (n = 267) were enrolled and completed interviews and child spirometry at baseline and 3, 6, 9, and 12 months postenrollment. A 12 month retrospective children's medical record review was completed. Participants were recruited from two school-based health clinics and the Breathmobile in Phoenix, AZ, and two inner-city hospital asthma clinics in the Bronx, NY. Results: Statistically significant differences in the social/ contextual predictors of asthma illness representations (IRs) were noted between Mexican and Puerto Rican caregivers. The structural equation model results revealed differences in asthma control over time by ethnicity. This model accounted for 40%-48% of the variance in asthma control test scores over 12 months. Caregivers' IRs aligned with the professional model of asthma management were associated with better children's asthma control across 1 year. These results also supported the theoretical notion that IRs change over time impacting caregivers' treatment decisions and children's asthma control. Conclusions: These findings extend a previous cross-sectional model test using a more comprehensive model and longitudinal data and highlight the importance of considering within-group differences for diagnosis and treatment of children coming from the vastly heterogeneous Latino umbrella group.
KW - Asthma ∙ Child ∙ Latino ∙ Health status disparities
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U2 - 10.1093/abm/kaz041
DO - 10.1093/abm/kaz041
M3 - Article
C2 - 31586174
AN - SCOPUS:85082342586
SN - 0883-6612
VL - 54
SP - 223
EP - 236
JO - Annals of Behavioral Medicine
JF - Annals of Behavioral Medicine
IS - 4
ER -