240319 Asthma, Neighborhood Stress, and CBPR: Engaging Community and Healthcare Provider Perceptions of Contextual Influences on Childhood Asthma

Tuesday, November 1, 2011: 9:15 AM

Michael Yonas, DrPH , School of Medicine, University of Pittsburgh, Pittsburgh, PA
Kimberly Rak, MA , Department of Anthropology, Department of Behavioral and Community Health Sciences, University Of Pittsburgh, Pittsburgh, PA
Shean Aujla, MD , Instructor of Pediatrics, Division of Pediatric Pulmonology, University of Pittsburgh School of Medicine, Pittsburgh, PA
Andrea Arrington, MPH , Program Director, Braddock Youth Project, Braddock, PA
Peter Asante , University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, PA
Anna Marsland, PhD, RN , Associate Professor of Psychology and Nursing, University of Pittsburgh, Pittsburgh, PA
Sally Wenzel, MD , Director, University of Pittsburgh Asthma Institute, UPMC/Univ of Pittsburgh SOM, Pittsburgh, PA
Introduction: Disproportionately high asthma morbidity and mortality exists among socioeconomically disadvantaged children living in urban areas. Growing evidence shows that exposure to chronic stress predicts future asthma exacerbations in children. However, the influence of neighborhood-level factors on stress and asthma morbidity among urban youth remains poorly understood. Methods: This mixed methods study was guided by principles of CBPR and utilized concept mapping methods to engage residents of two underserved communities as well as primary healthcare practitioners to identify and prioritize neighborhood factors that may influence, positively or negatively, childhood asthma. Study activities included brainstorming, sorting, rating and cluster mapping activities that characterized perceptions of the factors influencing the care and control of childhood asthma.

Results: Participants from the first site identified 72 discrete neighborhood level items that were related to asthma care and control. Construct items included pollution, stress, shootings, teasing, dust, health insurance, and smoking. Items were organized and prioritized by the group into 5 distinct clusters, including environmental triggers, community awareness of asthma and stressors. Data collection from a second site and from healthcare providers will be completed June 2011.

Conclusion: Utilization of a community partnered research approach led to the contextualization of a range of unique neighborhood-level factors not identified in existing literature. Results will generate testable hypotheses regarding neighborhood influences on childhood asthma care and inform the design of behavioral and public health asthma care and control programs for youth.

Learning Areas:
Social and behavioral sciences

Learning Objectives:
Describe the social and contextual influences upon care and control of childhood asthma Provide an overview and history the development of community asthma research guided by community-based participatory research (CBPR) program

Keywords: Asthma, Community-Based Health Promotion

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I oversee research related to youth, asthma, Community Based Participatory Research, and work that utilizes Concept Mapping.
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.