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Asthma risk factor assessment: what are the needs of inner-city families?
Karen Warman1, Ellen Johnson Silver, Pamela R Wood
1Department of Pediatrics, Children's Hospital at Montefiore/Albert Einstein College of Medicine, Bronx, New York 10461, USA. kwarman@montefiore.org
Insights
Inner-city children face numerous asthma risks, including environmental exposures and parental stress. Addressing these factors through comprehensive programs is crucial for reducing childhood asthma burdens.
Area of Science:
- Pediatric Allergy and Immunology
- Environmental Health
- Public Health
Background:
- Asthma morbidity remains a significant public health issue for inner-city children.
- A complex interplay of risk factors contributes to persistent asthma challenges in this population.
Purpose of the Study:
- To identify and describe key risk factors associated with asthma morbidity.
- Focus on a national sample of inner-city children diagnosed with persistent asthma.
Main Methods:
- Utilized baseline questionnaire data from 1,772 children (ages 5-11) in the Inner-City Asthma Intervention.
- Assessed risk across nine domains including environmental exposures, parental stress, and medication adherence using the Child Asthma Risk Assessment Tool.
- Included domains such as smoke exposure, aeroallergen sensitization, child psychological well-being, and medical care.
Main Results:
- Over half (51%) of families exhibited high asthma morbidity risk in three or more domains.
- Prevalent risk factors included household environmental exposures (47.7%), high parental stress (38.5%), and poor medication adherence (38.3%).
- Significant findings also noted pessimistic asthma beliefs (31.8%), environmental tobacco smoke (24.4%), and aeroallergen sensitization (24.8%).
Conclusions:
- Multiple risk factors for asthma morbidity were identified in a national sample of urban children.
- Highlights the need for multilevel support and intervention programs to mitigate asthma's impact on these families.
Background:
A complex array of risk factors contributes to sustained high levels of asthma morbidity in inner-city children.
Objective:
To describe risk factors for asthma morbidity in a national sample of inner-city children with persistent asthma.
Methods:
This study examined baseline questionnaire results from 1,772 children ages 5 to 11 years old with moderate to severe persistent asthma who enrolled in the Centers for Disease Control and Prevention-funded Inner-City Asthma Intervention between April 2001 and March 2004. Risk for asthma morbidity was assessed in 9 domains using the Child Asthma Risk Assessment Tool. The domains included environmental exposures, parental stress, medication adherence, pessimistic asthma beliefs, smoke exposure, aeroallergen exposure, child psychological well-being, responsibility for medication administration, and medical care.
Results:
A total of 51% of families demonstrated high risk of asthma morbidity in 3 or more domains. High risk of asthma morbidity was suggested based on household environmental exposures (47.7%), high parental stress (38.5%), poor medication adherence (38.3%), pessimistic asthma beliefs (31.8%), environmental tobacco smoke (24.4%), sensitization to aeroallergens in the home (24.8%), child behavioral or emotional concerns (22.9%), child assigned responsibility for medication administration (21.2%), and poor medical care (20.7%). Allergy testing was completed for 40% of the participating children. Of these children, 61% were exposed to aeroallergens in their home to which they were sensitized.
Conclusions:
In this national sample of inner-city children, multiple risk factors for asthma morbidity were identified. Asthma programs that provide multilevel support and intervention are needed to reduce the burden of asthma on inner-city families.
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