Effect of Ethnicity and Parental Illness Representation on Complementary and Alternative Medicine Usage and Asthma Control in Childhood Asthma

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Date

2015-05

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The Ohio State University

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Abstract

Background: Asthma is the most prevalent chronic condition in childhood in the US. Puerto Ricans (PR) are disproportionately affected compared to Mexicans (16% versus 5%, respectively). CAM usage in childhood asthma as high as 89% has been reported, but the evidence does not support CAM as an effective asthma management tool. Despite high CAM use, only 18% of parents reported CAM usage to the provider. There is potential to improve controller medication adherence while remaining sensitive to parents’ ethnomedical beliefs. Purpose: To explore lifetime and current prevalence, ethnic differences, and role of parental illness representations (IR) in CAM use and asthma control. Theory: The Common Sense Model of Illness Representation provides the theoretical framework. Subjects: 536 Latino parents and their children with asthma (aged 5-12 years). Families were recruited from 4 clinics located in Bronx, NY and Phoenix, AZ. Method: Longitudinal study of parental IRs, treatment decision, and asthma control. Structured interviews with parents (including questions about specific CAM therapies), short interviews with children, children’s lung function, and children’s medical records reviews were conducted at enrollment, and 3, 6, 9, and 12 months post-enrollment. Baseline data used for these analyses. Results: 74% of the sample reported lifetime CAM use. Significantly more Mexicans reported lifetime and current CAM use compared to PR (67% versus 33%, p=.04; 65% versus 35%, p=.01, respectively). Parental IRs were significant predictors of current CAM use (OR=.49, p=.05) but not lifetime CAM use. There was significant interaction of ethnicity and CAM (p=<.0001). Mexican children are significantly more likely to have well-controlled asthma, regardless of CAM/controller combination. Parental beliefs aligned with the professional asthma management model were predictive of well-controlled asthma (p=0.4). Conclusion: This study demonstrated that Mexicans and PRs have different IRs, CAM usage, and asthma control. It is important to understand IRs and CAM, so effective communication and shared decision-making can occur. HCPs who are familiar with and sensitive to IRs and care needs of diverse groups can play a decisive role in improving health outcomes of patients with asthma by heightened awareness of and respect for cultural differences among the children and families they interact with.

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Selected to attend MNRS conference
Selected for an oral presentation at Sigma Theta Tau International Convention

Keywords

childhood asthma, complementary and alternative medicine, asthma control, pediatrics

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