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Barriers to asthma management among urban families: caregiver and child perspectives

J Asthma. 2009 Sep;46(7):731-9. Laster N, Holsey CN, Shendell DG, McCarty FA, Celano M. Morehouse School of Medicine, Atlanta, Georgia, USA.

OBJECTIVE: Asthma is one of the most common chronic diseases of childhood. Those particularly affected are young, poor, African American children. Moreover, rates of emergency department visits, hospitalizations, and mortality are substantially higher for black children. Despite the ample published research on asthma prevalence and asthma management interventions, there is little research available on barriers to asthma care among urban, low-income families as perceived by children with asthma and their caregivers.

METHODS: This qualitative study analyzed data from five focus groups conducted with 28 participants in metropolitan Atlanta.

RESULTS: This study found caregiver and child health beliefs and perceptions concerning the use of daily controller medications to be a significant barrier to asthma care and proper self-management at home and at school. Barriers to environmental control consisted mostly of financial constraints, which made residential environmental remediation activities difficult to implement. Psychological distress was prevalent among both children and caregivers, which demonstrated the burden associated with managing a chronic illness.

CONCLUSION: Families in urban, low-income communities require asthma management interventions tailored to their specific characteristics, barriers, and challenges. Our findings can be used to inform and enhance asthma management interventions for urban families with children with asthma.

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