Agreement on smoking behavior and asthma medications among rural school age children with asthma, their parents and primary care providers (PCPs)

Abstract

Rationale Parental self-report of smoking behavior is often underestimated. We examined agreement between mothers' reports of smoking indoors and children's reports of mothers' smoking, and also agreement between parents' reports of child's asthma medications and primary care providers' (PCPs) reports. Methods Parental smoking behavior was collected by personal interviews of children with asthma in 3 rural MD counties. Parent reports of smoking behavior and the child's asthma medications were obtained from telephone surveys of 114 parents. Smoking behavior data was analyzed for 94 mother-child pairs. Information about children's asthma medications was obtained from 97 PCPs (85%). Medication agreement indicates agreement on drug name, frequency, dose and route. Results Children reported 15 mothers (16%) smoked indoors. Nine of these mothers reported not smoking indoors, while 7 children (78%) reported they did. Of the 6 smoking mothers who admitted to smoking indoors, 5 children (83%) stated that these mothers did (McNemar's chi-square <0.03). PCP reports indicated 141 prescriptions for rescue medications and 89 for controllers. For rescue medications, there was total agreement between parent and PCP on 111 (79%) prescriptions, and total agreement on 70 (79%) of the controller medications. Conclusions In this rural population, when smoking mothers reported that they did not smoke in the home, there was little agreement with their child's report. This finding indicates that it may be important to ask children with asthma about smoking in the home. Agreement between parents and PCPs on controller medication prescriptions was higher in this population than previously reported. This finding warrants further exploration.