Factors that predict which parents will address environmental asthma triggers

Abstract

Rationale Environmental control measures are an important component of asthma self-management. Methods We analyzed the prevalence of asthma triggers and the frequency of how often parents instituted environmental control measures. Subjects were from a national sample of 896 children with asthma; between 2 and 12 years of age; and with no other pulmonary diseases. We collected data on insurance, race, gender, household income, asthma education exposure and severity of illness. Results We completed interviews with the parents of 896 of 1077 eligible patients (83% response rate). Patients had a mean age of 7.2 years; 65% were male; 13% had Medicaid insurance; 12% were African-American; and 31% had persistent asthma. 717/896 (80%) parents could identify at least one trigger (mean=2.2 triggers; range 0 to 9). 582/717 (82%) parents that could identify a trigger had instituted at least one environmental control measure (mean=2.0 measures; range 0 to 9). The 896 parents reported instituting 1796 actions. 5/1796 (<1%) of these actions were harmful according to national guidelines; 916/1796 (51%) of these actions were not harmful, but not endorsed by national guidelines. In multivariate analysis, for parents that could identify a specific trigger, there were no demographic characteristics that were statistically significant and associated with which parents were more or less likely to institute environmental controls. Conclusions Clinicians should not assume that they can predict which families will be more or less likely to adhere to environmental control recommendations. Futhermore, half of the actions that families instituted were not officially endorsed by national guidelines.