Asthma is a significant public health problem affecting many children and considerable coordination within the family is required to manage asthma effectively. Research identifying family factors that contribute to successful management is crucial to the development of effective interventions to reduce asthma morbidity. Research on family asthma management has focused primarily on the mother-child dyad, and little is known about parental coordination of asthma care in two-parent families. How parents work together as a team in sharing asthma management tasks, the amount of parental conflict around asthma care, as well as the degree of congruence in maternal and paternal approaches to asthma management may significantly impact the child's health. The primary objective of this project is to investigate the associations between inter-parental processes surrounding asthma care and child asthma outcomes. Three key predictor variables will be examined: 1) Parental conflict around asthma management, 2) Parental congruence, or the degree to which parents hold similar beliefs about asthma medication and have similar approaches to asthma management, and 3) Parental collaboration, or the degree to which parents work together and support each other in the care of their child's asthma. Two main outcomes, adherence to daily preventive medications and asthma control, will be investigated. Participants will include 110 two-parent families with a child between the ages of 5 and 9 years who has persistent asthma. The child's actual controller medication use will be electronically monitored for a period of 1 month, and families will then participate in an interview based assessment on family processes and asthma management. Parent report will provide information on asthma control. It is proposed that parental collaboration will positively impact child health outcomes, while parental incongruence (i.e. mother and father have different beliefs or approaches) and parental conflict will have a high degree of negative impact on asthma outcomes. Results of the proposed study will provide the foundation for future family based interventions to enhance adaptive family system involvement in pediatric asthma management.

Public Health Relevance

Asthma is a significant public health problem, and considerable coordination within the family is required to manage asthma effectively. Little is known, however, about parental coordination of asthma care in two-parent families. Results of the proposed study will provide the foundation for future family-based interventions that include both parents to enhance adaptive management of pediatric asthma.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Small Research Grants (R03)
Project #
1R03HD055322-01A2
Application #
7587677
Study Section
Special Emphasis Panel (ZHD1-DSR-M (HB))
Program Officer
Haverkos, Lynne
Project Start
2009-02-01
Project End
2011-01-31
Budget Start
2009-02-01
Budget End
2010-01-31
Support Year
1
Fiscal Year
2009
Total Cost
$88,167
Indirect Cost
Name
Massachusetts General Hospital
Department
Type
DUNS #
073130411
City
Boston
State
MA
Country
United States
Zip Code
02199
Friedman, Deborah; Masek, Bruce; Barreto, Esteban et al. (2015) Fathers and Asthma Care: Paternal Involvement, Beliefs, and Management Skills. J Pediatr Psychol 40:768-80