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. 2025 Oct;40(10):1612-1632.
doi: 10.1080/08870446.2024.2347657. Epub 2024 Apr 29.

Managing children's asthma: what role do caregivers' mental representations of trigger and symptom management behaviors play?

Erika A Waters  1 , Thorsten Pachur  2   3 , Gabrielle Pogge  4 , Jean Hunleth  1 , Gregory D Webster  4 , David A Fedele  4 , James A Shepperd  4
Affiliations

Managing children's asthma: what role do caregivers' mental representations of trigger and symptom management behaviors play?

Erika A Waters et al. Psychol Health. 2025 Oct.

Abstract

Objective: Pediatric asthma management is challenging for parents and guardians (hereafter caregivers). We examined (1) how caregivers mentally represent trigger and symptom management strategies, and (2) how those mental representations are associated with actual management behavior.

Methods: In an online survey, N = 431 caregivers of children with asthma rated 20 trigger management behaviors and 20 symptom management behaviors across 15 characteristics, and indicated how often they engaged in each behavior.

Results: Principal components analysis indicated 4 dimensions for trigger management behaviors and 3 for symptom management behaviors. Bayesian mixed-effects models indicated that engagement in trigger management behavior was more likely for behaviors rated as affirming caregiver activities. However, trigger management behavior did not depend on how highly the behavior was rated as challenging for caregiver, burdensome on child, or routine caregiving. Engagement in symptom management behavior was more likely for behaviors rated as affirming and common and harmless to the child, but was unrelated to how highly a behavior was rated as challenging for caregivers.

Conclusion: These results suggest that interventions might be particularly useful if they focus on the affirming nature of asthma management behaviors. However, such interventions should acknowledge structural factors (e.g. poverty) that constrain caregivers' ability to act.

Keywords: Asthma; adolescent; behavior; child; parent.

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Conflict of interest statement

Declaration of Conflicts of Interest: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Declaration of Conflicts of Interest

The Authors declare that there are no conflicts of interest.

Figures

Figure 1.
Figure 1.. The proportion of caregivers who reported engagement in each asthma trigger management behavior (left-hand graph) and in each asthma symptom management behavior (right-hand graph).
Note. Behaviors are ordered by the proportion of caregivers reporting engagement in the respective management behavior from high (at the top of the graph) to low (at the bottom of the graph).
Figure 2.
Figure 2.
Two-dimensional factor space depicting caregivers’ mental representations of (A) trigger management behaviors and (B) symptom management behaviors. Note. The label on the bottom of each factor space represents the horizontal axis (e.g., “affirming caregiver behaviors” located on the left-hand side of panel A). The label to the left of each factor space represents the vertical axis (e.g., “challenging for caregiver” located on the left-hand side of panel A).
See this image and copyright information in PMC

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