Predictors of treatment adherence among African American and Hispanic parents of children with poorly controlled asthma in East Harlem, New York City (NYC)

Objective:To examine the effects of parents' perceptions of medications on their children's adherence with asthma treatment. A questionnaire and in-depth interviews were conducted with black and Hispanic parents with children diagnosed with poorly controlled asthma. Perceptions of medication: efficacy, side effects, compliance; and relationship with child's doctor and history of recent hospitalizations were assessed. Participants (n=99) were more likely to be female (91%) and Hispanic (62%), but 37% were black. Sixty-three percent were unemployed; while of those who said they were employed, 69% earned less than $20,000 annually. Most of the children (71%) were diagnosed with asthma between 0-3 yrs. Although an overwhelming percentage of respondents disagreed that asthma medications were not helpful in managing asthma (82.5%), they were unlikely to be adherent with treatment. There was an association between parents' race/ethnicity and medication belief: more Hispanic respondents (50%) than Blacks (40%) believe doctors prescribe too many medications; 55.1% (AA 25%; H 31%; p-value, .027) strongly/agreed that doctors do not give helpful information, although 72% said language was not a problem when communicating with their doctor. More than half of the respondents (47.5%) believe that asthma medications are too powerful for children. There was an association between frequency of hospitalizations and missed medications (p=0.004). Most of the participants in the in-depth interviews (n=50) cited the absence of symptoms as one of the reasons for lack of adherence. These results will facilitate better understanding of the factors that affect medication compliance among minority populations and contribute to tailoring individual parent education and case management.