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Randomized Controlled Trial
. 2018 Jul-Aug;32(4):387-398.
doi: 10.1016/j.pedhc.2017.12.009. Epub 2018 Mar 12.

Improving Care of Inner-City Children with Poorly Controlled Asthma: What Mothers Want You to Know

Melissa H Bellin, Angelica Newsome, Cassie Lewis-Land, Joan Kub, Shawna S Mudd, Rachel Margolis, Arlene M Butz
Randomized Controlled Trial

Improving Care of Inner-City Children with Poorly Controlled Asthma: What Mothers Want You to Know

Melissa H Bellin et al. J Pediatr Health Care. 2018 Jul-Aug.

Abstract

Introduction: Low-income caregiver perspectives on asthma management are understudied but may illuminate strategies to improve care delivery and child outcomes.

Method: Purposive sampling methods were used to recruit 15 caregivers of children with frequent asthma emergency department visits. Interviews explored how poverty and stress affect asthma management. Grounded theory coding techniques were used to analyze the data.

Results: Participants were the biological mother (100%) and were poor (75% had mean annual income ≤ $30,000). Their children (mean age = 6.9 years) were African American (100%), enrolled in Medicaid (100%), and averaged 1.5 emergency department visits over the prior 3 months. Four themes emerged: (a) Deplorable Housing Conditions, (b) Allies and Adversaries in School-Based Asthma Management, (c) Satisfaction With Asthma Health Care Delivery, and (d) Prevalent Psychological Distress.

Discussion: Impoverished caregivers of children with frequent asthma emergency department visits describe stress that is multifaceted, overwhelming, and difficult to eradicate. Their experiences underscore the need for improved school-based asthma management and family-centered approaches to health care delivery.

Trial registration: ClinicalTrials.gov NCT01981564.

Keywords: Asthma management; caregiver; poverty; provider relationships; stress.

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Conflict of interest statement

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

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