Caregiver Asthma-Related Quality of Life in an Environmental Intervention Study to Alleviate Childhood Asthma Symptoms

Abstract

ISEE-341 Objective: Recent studies have documented asthma symptom improvements among urban children with indoor allergen-reducing environmental interventions. Less attention has been attributed, however, to auxiliary effects on caregivers and other family members. The Healthy Public Housing Initiative (HPHI), a collaboration of university, government, and community partners, explored whether indoor environmental interventions (intensive cleaning, integrated pest management) may alleviate symptoms among urban children, and which factors may influence benefits for children and caregivers. Material and Methods: Trained Community Health Advocates visited with families monthly, administered Juniper Asthma Quality of Life (QOL) questionnaires for child and caregiver, and collected reports of child's symptoms, unplanned ED/clinic visits, and medication use. Data on perceived stress, violence exposures, and social support were also collected monthly for caregivers. Monthly quality-of-life data were analyzed for 51 caregivers of 58 asthmatic children in 3 public housing developments over 13 months. Longitudinal analysis with random intercepts was used to explore caregiver QOL improvements over the course of study, and in multiple periods. Several pathways for benefits in caregiver QOL are being explored, including (1) improvements in child's QOL, (2) direct influence of environmental improvements, (3) improved social support, and (4) asthma management. Results: Longitudinal analyses indicate significant improvement in caregiver QOL over the course of study. As previously shown for child's symptoms and QOL, caregivers show significant improvements in QOL before environmental intervention, indicating potential benefits of case management and support. Further analyses will explore the roles of social support and participation effects in predicting these preintervention QOL benefits. Conclusions: Results suggest that benefits of environmental interventions may be due to social as well as environmental aspects of intervention. Further analyses will explore the role of social support, caregiver stress, and other factors to explain observed improvements in caregiver QOL.