Beliefs about and responses to childhood ear infections: a study of parents in eastern North Carolina.

Middle ear infection, also known as otitis media (OM), is a major public health problem among American children. Although clinical and epidemiological aspects of OM have been intensely studied, cultural factors that may be contributing to the problem of OM have received less attention. This article presents findings from an ethnographic study exploring beliefs about OM and responses to the illness among parents from eastern North Carolina. In-depth interviews were conducted with a convenience sample of nine mothers in order to learn more about parents' explanatory models of OM, the source of their beliefs, and how they respond to the illness. A survey instrument based on their statements was then constructed and administered to a convenience sample of 79 parents. The survey consisted of belief statements about OM, as well as questions pertaining to sources of beliefs, the home management of the disease, and the effects of the illness on families. A cultural consensus analysis of responses to belief statements indicates that parents shared a common model of OM. Beliefs about risks, symptoms, and causes of OM were similar to the current biomedical model of the illness, but their divergent beliefs about the diagnosis, prognosis and treatment of OM could lead to unnecessary use of health care services. Clinicians, family, and friends were reported to be important sources of information about OM. Parents also reported using similar home management strategies and care seeking behaviors to minimize the impact of the illness on their children and families. While these findings need to be replicated in studies with larger, more representative samples, this study suggest that ethnographic approaches may provide new insights into the cultural dimension of the problem of OM.