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APHA Scientific Session and Event Listing

Leanne S. Yinusa-Nyahkoon, MS¹, Ellen S. Cohn, ScD¹, Barbara G. Bokhour, PhD², and Dharma Cortes, PhD³. (1) Dept. of Occupational Therapy and Rehabilitation Counseling, Boston University, Sargent College, 635 Commonwealth Ave., Boston, MA 02215, (617) 358-1063, lyinusa@hotmail.com, (2) Health Services/ Center for Health Quality, Outcomes & Economic Research, Boston University School of Public Health, ENRM Veterans Hospital, 200 Springs Road (152), Bedford, MA 01742, (3) Department of Psychiatry, Cambridge Health Alliance/Harvard Medical School, 1493 Cambridge Street, Cambridge, MA 02139

Asthma, a common chronic childhood disease, is considered a national epidemic. Asthma affects 4.4 million children in the U.S, the majority of who are minorities. In 2005, 16.5% of African American children between birth and 17 years of age were diagnosed with asthma compared with 11.9% of non-Hispanic white children. In addition to higher asthma prevalence, African-American children also experience increased rates of asthma severity, symptom prevalence, disability, hospitalizations, emergency room visits, medication non-adherence, and mortality due to asthma than children of any other racial group. Eliminating these racial disparities is a national priority, and national guidelines suggest that future research examine cultural, family, and environmental factors to better understand why asthma disparities continue to exist. A better understanding of cultural explanatory models of asthma may provide insight into factors that contribute to the asthma disparities that exist within the African-American community. African-American parents of children aged 5 to 12 years diagnosed with persistent asthma participated in semi-structured qualitative interviews. Participants were recruited from the pediatric clinics of a large inner-city medical center and a multi-specialty provider group. 19 parents participated in an initial 1 ½ hour interview, and 11 of these parents participated in a follow-up interview approximately 1 year later. Interviews focused on understanding the family's experience of living with a child with asthma, the social and economic context, interactions with health care providers, parents' goals for asthma management, asthma management routines, and medication use. Parents were interviewed by an African-American investigator. All interviews were transcribed by a professional transcription service, and then reviewed by the investigator for accuracy. Interview data was analyzed using both sociolinguistic analysis and thematic analysis with a grounded theory structure. This paper will describe the explanatory models of asthma of African-American parents of children with asthma. Explanatory models integrate parental perceptions, cultural norms, and past experiences, and function as a mechanism to explain beliefs about asthma and guide treatment choices. Findings reveal that parents share commonalities and differences in their explanatory models including beliefs about their child's asthma etiology, pathophysiology, time and onset of symptoms, course of illness, and treatment. Implications for intervention including factors health care providers may consider during asthma assessment and intervention planning will be described. A better understanding of African-American parents'explanatory models of asthma may enable health care providers to develop culturally tailored interventions designed to reduce the asthma disparities that exist within the African-American community.

Learning Objectives:

• Identify 5 components of a cultural explanatory model of asthma
• Understand the cultural explanatory models of asthma of African-American parents of children with asthma
• Describe family, cultural, and environmental factors to consider during asthma assessment and intervention planning

Presenting author's disclosure statement:

Not Answered