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Parental management of asthma triggers within a child's environment
Michael D Cabana1, Kathryn K Slish, Toby C Lewis
1Department of Pediatrics, University of Michigan Health System, Ann Arbor, MI 48109-0456, USA. mcabana@med.umich.edu
Insights
Many families attempt to control asthma triggers, but over half of their actions are ineffective. Improving awareness of evidence-based environmental control methods is crucial for better asthma self-management.
Area of Science:
- Pediatric Allergy and Immunology
- Environmental Health
- Public Health
Background:
- Asthma self-management includes controlling environmental triggers.
- Effective management of childhood asthma necessitates addressing environmental factors.
- Environmental control is a key component of asthma self-care.
Purpose of the Study:
- To evaluate the types and frequency of family-led environmental control strategies for asthma.
- To assess the alignment of these strategies with current asthma management guidelines.
- To understand parental approaches to managing childhood asthma triggers.
Main Methods:
- Analysis of data from a nationwide sample of 896 children (aged 2-12) with asthma.
- Parents were interviewed about their child's asthma triggers and control actions.
- Data collected included demographics, insurance, and asthma education exposure.
Main Results:
- 80% of parents identified asthma triggers, and 82% attempted control measures.
- Over half (51%) of initiated environmental control actions were not supported by current guidelines.
- Demographic factors did not predict the likelihood of parents implementing environmental controls.
Conclusions:
- A significant proportion of asthma environmental control actions are not guideline-recommended.
- Enhanced education on effective trigger management is needed for families.
- Clinicians should provide consistent education on environmental control for all families with modifiable asthma triggers.
Background:
Control of environmental precipitants of asthma is an important component of self-management.
Objective:
To assess the type and frequency of attempts by families to control environmental precipitants of symptoms and their degree of consistency with current guidelines.
Methods:
We analyzed data from a nationwide sample of 896 children (2-12 years) with asthma. We collected data on insurance, race, sex, income, asthma education exposure, and severity. Parents were asked open-ended questions about their child's asthma triggers and what, if any, actions they took to control these triggers.
Results:
We completed interviews with the parents of 896 of 1077 (83%) eligible patients. Patients had a mean age of 7.2 years, 65% were boys, 13% had Medicaid insurance, 12% were African American, and 31% had persistent asthma. Eighty percent (717/896) of parents could identify at least 1 asthma trigger (mean, 2.2; range, 0-9). Eighty-two percent (582/717) of these parents had attempted an environmental control measure. Of 1788 actions initiated, 916 (51%) were unlikely to be beneficial on the basis of current guidelines. No specific demographic characteristic predicted which parents were more or less likely to institute environmental controls.
Conclusion:
In our sample, more than half (51%) of the environmental actions initiated were not specifically endorsed by current guidelines. Improving awareness about recognized methods to address triggers may help families use more effective measures. Clinicians should not assume that they can predict which families will be more or less likely to attempt environmental control, but should provide education regarding effective environmental measures for all families with potentially modifiable asthma triggers
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