Ann Chen Wu1, Lauren Smith, Barbara Bokhour, Katherine H Hohman, Tracy A Lieu. 1. Center for Child Health Care Studies, Department of Ambulatory Care and Prevention, Harvard Pilgrim Health Care and Harvard Medical School, Boston, MA 02215-5301, USA. ann.wu@childrens.harvard.edu
Abstract
OBJECTIVE: Black and Latino children with asthma have worse morbidity and receive less controller medication than their white peers. Scant information exists on racial/ethnic differences in parent perceptions of asthma. To compare parent perceptions among black, Latino, and white children with asthma in 4 domains: (1) expectations for functioning with asthma; (2) concerns about medications; (3) interactions with providers; and (4) competing family priorities. METHODS: In this cross-sectional study, we conducted telephone interviews with parents of children with persistent asthma in a Medicaid health plan and a multispecialty provider group in Massachusetts. To measure expectations for functioning and other domains, we adapted multi-item scales from past studies. Associations between race/ethnicity and these domains were evaluated in multivariate analyses that controlled for age, gender, household income, parental education, insurance, and language. The response rate was 72%. RESULTS: Of the 739 study children, 24% were black, 21% Latino, and 43% white. Parents of black and Latino children had lower expectations for their children's functioning with asthma (P < .001), higher levels of worry about their children's asthma (P < .001), and more competing family priorities (P = .004) compared with parents of white children. Parents of Latino children had higher levels of concern about medications for asthma than parents of black or white children (P = .002). There were no differences among racial/ethnic groups in reports of interactions with the provider of their children's asthma care. CONCLUSIONS: Efforts to eliminate disparities in childhood asthma may need to address variation in expectations and competing priorities between minority and white families.
OBJECTIVE: Black and Latino children with asthma have worse morbidity and receive less controller medication than their white peers. Scant information exists on racial/ethnic differences in parent perceptions of asthma. To compare parent perceptions among black, Latino, and white children with asthma in 4 domains: (1) expectations for functioning with asthma; (2) concerns about medications; (3) interactions with providers; and (4) competing family priorities. METHODS: In this cross-sectional study, we conducted telephone interviews with parents of children with persistent asthma in a Medicaid health plan and a multispecialty provider group in Massachusetts. To measure expectations for functioning and other domains, we adapted multi-item scales from past studies. Associations between race/ethnicity and these domains were evaluated in multivariate analyses that controlled for age, gender, household income, parental education, insurance, and language. The response rate was 72%. RESULTS: Of the 739 study children, 24% were black, 21% Latino, and 43% white. Parents of black and Latino children had lower expectations for their children's functioning with asthma (P < .001), higher levels of worry about their children's asthma (P < .001), and more competing family priorities (P = .004) compared with parents of white children. Parents of Latino children had higher levels of concern about medications for asthma than parents of black or white children (P = .002). There were no differences among racial/ethnic groups in reports of interactions with the provider of their children's asthma care. CONCLUSIONS: Efforts to eliminate disparities in childhood asthma may need to address variation in expectations and competing priorities between minority and white families.
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