PSYCHOSOCIAL CHARACTERISTICS OF INNER-CITY CHILDREN WITH ASTHMA - A DESCRIPTION OF THE NCICAS PSYCHOSOCIAL PROTOCOL

Previous research has demonstrated a significant reciprocal relationsh ip between psychosocial factors and asthma morbidity in children. The National Cooperative Inner-City Asthma Study investigated both asthma- specific and non-specific psychosocial variables, including asthma kno wledge beliefs and management behavior, caregiver and child adjustment , life stress, and social support. This article presents these psychos ocial characteristics in 1,528 4-9-year-old asthmatic urban children a nd their caretakers. Caretakers demonstrated considerable asthma knowl edge, averaging 84% correct responses on the Asthma Information Quiz. However, respondents provided less than one helpful response for each hypothetical problem situation involving asthma care, and most respond ents had more than one undesirable response, indicating a potentially dangerous or maladaptive action. Both adults and children reported mul tiple caretakers responsible for asthma management (adult report: aver age 3.4, including the child); in addition, children rated their respo nsibility for self-care significantly higher than did adults. Scores o n the Child Behavior Checklist indicated increased problems compared t o normative samples (57.3 vs. 50, respectively), and 35% of children m et the criteria for problems of clinical severity. On the Brief Sympto m Inventory, adults reported elevated levels of psychological distress (56.02 vs norm of 50); 50% of caretakers had symptoms of clinical sev erity. Caretakers also experienced an average of 8.13 undesirable life events in the 12 months preceding the baseline interview. These findi ngs suggest that limited asthma problem-solving skills, multiple asthm a managers, child and adult adjustment problems, and high levels of li fe stress are significant concerns for this group and may place the in ner-city children in this study population at increased risk for probl ems related to adherence to asthma management regimens and for asthma morbidity. (C) 1997 Wiley-Liss, Inc.