The central aim of this longitudinal study, funded by the NHLBI (1-R01-HL53391) is to clarify the extent to which and the mechanisms whereby specific family processes may be protective or deleterious to adherence behaviors and treatment outcome in 3 groups of asthmatic children, aged 7-12 years: 80 children participating in the Denver site of the Childhood Asthma Management Program (CAMP), 80 children receiving asthma-related care in a large, state-of-the-art, health maintenance organization, and 60 children recruited by using school records to identify children with asthma receiving their care in a variety of different health care systems. The three primary specific aims are: (1) to examine the extent to which family process variables are cross-sectionally associated with and longitudinally influence adherence to asthma treatment, as well as the consistency of this relationship across the three sites -- a clinical trial sample, a managed care sample, and a community treatment sample; (2) to examine the extent to which family process variables are cross-sectionally associated with and longitudinally influence asthma treatment outcome, as well as the consistency of this relationship across the three sites; (3) to determine whether adherence with treatment mediates the relationship between specific family processes and asthma treatment outcome, as well as the consistency of this relationship across the three sites. To date the sample of over 200 children and their families has been recruited and longitudinal follow-up continues. Behavioral coding of these data is being facilitated by the GCRC Psychosocial Assessment Core Laboratory.
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