Stress Coping Social Support And Childhood Asthma Among African American Families PDF Download

Abstract: African-American children demonstrate poorer asthma outcomes than children of any other racial group, and poor asthma management has been identified as a contributing factor. Researchers suggest cultural beliefs about health and illness may influence families' approach to asthma management, and encourage health care providers to examine these beliefs during the clinical encounter. Beliefs, however, do not directly translate into asthma management behaviors. From an ecocultural perspective, asthma management is a compromise between what is desirable according to cultural beliefs and practical within a family's ecological context. Ecological barriers, or social and environmental constraints, to asthma management have been identified, yet little is known about the factors underlying these barriers or how African-American parents navigate these barriers to manage their children's asthma. Furthermore, it remains unclear what African-American parents believe health care providers can do to support parents as they manage asthma within their ecological context. According to family-centered care, parents are experts of their families and asthma management experiences. Therefore, through semi-structured interviews this dissertation examines the perspective of 19 African-American parents of children with asthma living in the inner-city. Data analysis identifies four adaptive routines parents use to manage asthma within their ecological context: (1) give young children with asthma responsibility for medication use, (2) monitor the availability of the school nurse, (3) manage air quality, and (4) frequently clean the home, as well as three roles parents believe health care providers have in supporting asthma management: (1) prescribing environmental control resources, (2) assisting parents in accessing resources for daily family life, and (3) providing ongoing education for parents and school personnel. Findings indicate that parents desire health care providers who understand their ecological context. Examining family routines is presented as a practical approach that health care providers can use to understand the daily and socio-historical context of African-Americans living in the inner city. Collaboration among families, health care providers, policy makers, researchers, and public health advocates to minimize the existing childhood asthma disparity, and improve the health of African-American children with asthma is indicated.