219859 Predictors of treatment adherence among African American and Hispanic parents of children with poorly controlled asthma in East Harlem, New York City (NYC)

Monday, November 8, 2010 : 11:29 AM - 11:47 AM

Veronica N. Uzoebo, EdD, MS, MA , District Public Health Office, Harlem, NYC Dept. of Health and Mental Hygiene, New York, NY
Betty Perez-Rivera, EdD, CHES , East Harlem Asthma Center of Excellence, District Public Health Office, NYC Dept. of Health and Mental Hygiene, New York, NY
Gretchen Van Wye, PhD , District Public Health Office, Harlem, NYC Department of Health and Mental Hygiene, New York, NY
Syncia Sabain, EdD , Borough of Manhattan Community College, New York, NY
George Perez, MSW , District Public Health Office, New York City Department of Health & Mental Hygiene, New York, NY
Rebecca Lambert, MPH , School of Medicine, Columbia University, New York, New York City, NY
Hannah Seoh, MPH , District Public Health Office, Harlem, New York City Department of Health & Mental Hygiene, New York City, NY
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.

Learning Areas:
Assessment of individual and community needs for health education
Chronic disease management and prevention
Environmental health sciences
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Program planning

Learning Objectives:
1. To identify factors affecting adherence with asthma treatment among Black and Hispanic parents of children with poorly controlled asthma in a low income, asthma prevalent neighborhood in NYC 2. To examine the socio-cultural context for the disproportionate prevalence of asthma related ED visits and hospitalization among children with asthma in Harlem compared with other parts of the city 3. To examine the relationship between parent –doctor communication on parents ability to manage children’s asthma

Keywords: Disease Management, Health Disparities

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I oversee program evaluation and planning functions in a large public heatlh agency, working in areas such as disease prevention and health promotion programs
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.