An intervention to increase caregiver support for asthma management in middle school-aged youth

Abstract

Objective: Asthma control requires adherence to a treatment regimen. Caregiver involvement is a key determinant of adolescent asthma control, but the involvement must recognize the youth's developmental stage and need for autonomy. This article describes the evaluation of a pilot asthma management intervention for middle school-aged youth and their adult network members, including caregivers, based on caregiver findings.

Methods: Following approval from San Diego State University's Institutional Review Board and school district authorization, two middle schools were randomized into one of two conditions: 6-weekly group-based skills training for the adolescents followed by 6-weekly targeted newsletters for caregivers and others (Group 1) versus group-based skills training for adolescents only (Group 2). Outcome evaluation examined pre-post changes by study condition.

Results: Caregivers in both groups reported improvements in quality of life (QOL) and access to asthma care resources among their adolescents. Caregiver self-efficacy increased significantly among Group 1 versus Group 2 caregivers, while Group 2 caregivers (those who did not receive newsletters) reported that their adolescents had more responsibility for their asthma care compared with Group 2 caregivers.

Conclusions: The adolescent-only intervention resulted in improvements in caregivers' QOL and parenting behaviors that promoted the adolescent's access to asthma resources. When caregivers were directed with intervention materials, their self-efficacy increased. Those who did not receive materials reported that their adolescents had more responsibility for their asthma care. The latter finding may reflect an unintended consequence of an adolescent-only intervention as it may communicate to caregivers to assume less responsibility for their child's asthma care.