Caregiver perception of asthma management of children in the context of poverty

Melissa H. Bellin, Cassie Land, Angelica Newsome, Joan Kub, Shawna S Mudd, Mary Elizabeth Bollinger, Arlene Manns Butz

Research output: Contribution to journalArticle

Abstract

Objective: Low-income caregivers of young children with high-risk asthma experience social stressors and illness-related demands that may impede effective home asthma management. Knowledge of the caregiving experience in the context of poverty is limited. Methods: Convenience sampling methods were used to recruit low-income caregivers of children aged 7–12 years, who are frequently in the Emergency Room (ED) for uncontrolled asthma. Thirteen caregivers participated in focus groups that were designed to elicit reflections on asthma home and community management from the caregiver perspective. A grounded theory approach was used in the open coding of transcript data from three focus groups, as well as to revise and reorganize emerging themes and sub-themes. Results: Participants (Mean age = 33.9 years) were predominantly the biological mother (92.3%), single (84.6%), and impoverished (69.2% reported annual household income ≤ $30,000). Their children (Mean age = 7.8 years) were African-American (100%), enrolled in Medicaid (92.3%), averaged 1.38 (SD = 0.7) ED visits over the prior 3 months, resided in homes with at least one smoker (61.5%), and nearly all (84.6%) experienced activity limitations due to asthma. Five themes emerged in the analysis: intensive caregiving role, complex and shared asthma management responsibility, parental beliefs and structural barriers to guideline-based care, lack of control over environmental triggers, and parent advocacy to improve child asthma care and outcomes. Conclusions: Caregivers managing a child with high-risk asthma in the context of poverty indicate the need for ongoing asthma education, increased sensitivity to the complexity of home asthma management, and family-centered interventions that enhance communication and collaboration between caregivers and providers.

Original languageEnglish (US)
Pages (from-to)1-11
Number of pages11
JournalJournal of Asthma
DOIs
StateAccepted/In press - Oct 3 2016

Fingerprint

Poverty
Caregivers
Asthma
Focus Groups
Medicaid
Child Care
African Americans
Hospital Emergency Service
Communication
Mothers
Guidelines
Education

Keywords

  • Asthma
  • caregiver
  • focus groups
  • low-income
  • medication use
  • stress

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Immunology and Allergy
  • Pulmonary and Respiratory Medicine

Cite this

Caregiver perception of asthma management of children in the context of poverty. / Bellin, Melissa H.; Land, Cassie; Newsome, Angelica; Kub, Joan; Mudd, Shawna S; Bollinger, Mary Elizabeth; Butz, Arlene Manns.

In: Journal of Asthma, 03.10.2016, p. 1-11.

Research output: Contribution to journalArticle

Bellin, Melissa H. ; Land, Cassie ; Newsome, Angelica ; Kub, Joan ; Mudd, Shawna S ; Bollinger, Mary Elizabeth ; Butz, Arlene Manns. / Caregiver perception of asthma management of children in the context of poverty. In: Journal of Asthma. 2016 ; pp. 1-11.
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