BACKGROUND:Puerto Rican children have the highest prevalence of asthma, but detailed descriptions of this population have been limited to the island of Puerto Rico and the northeastern United States. OBJECTIVE: To describe the asthma characteristics of this urban Midwest cohort of Puerto Rican youth, focusing on medication behaviors, and to test whether their asthma outcomes are associated with their demographic and psychosocial variables. METHODS: Data are from the baseline cohorts of a randomized controlled trial designed to improve medication adherence in Puerto Rican youth. Recruitment used a community-based participatory research approach. Data were collected in the home. Medications and medication technique were visually assessed, and adherence was determined using electronic medication monitors or counters. Data on asthma symptoms and morbidity, demographics, and psychosocial factors were collected. RESULTS: The recruitment of 101 participants (51 in elementary school and 50 in high school) was completed in 14 months. Despite overall high asthma severity and poor asthma control, 20% of participants had no reliever medicine in their home. Self-report of controller use was higher than actual controller medications visualized in the home. For those who had an inhaled corticosteroid medicine (only 45% of elementary school participants and 12% of high school participants), median adherence was 1.0 doses per day. Rates of depression and stress were very high among both caregivers and children. CONCLUSION:Puerto Rican youth in the Midwest bear a significant asthma burden in addition to other stressors, including depression. Visual inspection of medications and monitoring of adherence are critical for understanding asthma morbidity in this high-risk population.
RCT Entities:
BACKGROUND: Puerto Rican children have the highest prevalence of asthma, but detailed descriptions of this population have been limited to the island of Puerto Rico and the northeastern United States. OBJECTIVE: To describe the asthma characteristics of this urban Midwest cohort of Puerto Rican youth, focusing on medication behaviors, and to test whether their asthma outcomes are associated with their demographic and psychosocial variables. METHODS: Data are from the baseline cohorts of a randomized controlled trial designed to improve medication adherence in Puerto Rican youth. Recruitment used a community-based participatory research approach. Data were collected in the home. Medications and medication technique were visually assessed, and adherence was determined using electronic medication monitors or counters. Data on asthma symptoms and morbidity, demographics, and psychosocial factors were collected. RESULTS: The recruitment of 101 participants (51 in elementary school and 50 in high school) was completed in 14 months. Despite overall high asthma severity and poor asthma control, 20% of participants had no reliever medicine in their home. Self-report of controller use was higher than actual controller medications visualized in the home. For those who had an inhaled corticosteroid medicine (only 45% of elementary school participants and 12% of high school participants), median adherence was 1.0 doses per day. Rates of depression and stress were very high among both caregivers and children. CONCLUSION: Puerto Rican youth in the Midwest bear a significant asthma burden in addition to other stressors, including depression. Visual inspection of medications and monitoring of adherence are critical for understanding asthma morbidity in this high-risk population.
Authors: Jonathan M Feldman; Edna Acosta Pérez; Glorisa Canino; Elizabeth L McQuaid; Renee D Goodwin; Alexander N Ortega Journal: J Nerv Ment Dis Date: 2011-05 Impact factor: 2.254
Authors: Cynthia A Esteban; Robert B Klein; Elizabeth L McQuaid; Gregory K Fritz; Ronald Seifer; Sheryl J Kopel; Jose Rodriguez Santana; Angel Colon; Maria Alvarez; Daphne Koinis-Mitchell; Alexander N Ortega; Brenda Martinez-Nieves; Glorisa Canino Journal: J Allergy Clin Immunol Date: 2009-07-16 Impact factor: 10.793
Authors: Giselle Mosnaim; Hong Li; Molly Martin; DeJuran Richardson; Paula Jo Belice; Elizabeth Avery; Norman Ryan; Bruce Bender; Lynda Powell Journal: J Allergy Clin Immunol Pract Date: 2013-08-30
Authors: Molly A Martin; Steven K Rothschild; Elizabeth Lynch; Katherine Kaufer Christoffel; Militza M Pagán; Jose Luis Rodriguez; Anna Barnes; Kelly Karavolos; Antonieta Diaz; Lucretia M Hoffman; Diana Plata; Sandra Villalpando Journal: BMC Pediatr Date: 2016-12-01 Impact factor: 2.125