The Effects of Caregiver Social Support and Depressive Symptoms on Child Medication Adherence and Asthma Control
| Autor: | Mary E. Bollinger, Sarah Dababnah, Rachel H.F. Margolis, Arlene M. Butz, Brenda Jones-Harden, Melissa H. Bellin, Paul Sacco |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Health (social science) Sociology and Political Science Psychological intervention Article Medication Adherence law.invention Social support 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Epidemiology medicine Humans Family 030212 general & internal medicine Child Psychiatry Generalized estimating equation Asthma 030505 public health Depression business.industry Health Policy Depressive symptoms Public Health Environmental and Occupational Health Social environment Center for Epidemiologic Studies Depression Scale Caregiver medicine.disease respiratory tract diseases Caregivers Black Anthropology Female 0305 other medical science business |
| Zdroj: | Journal of Racial and Ethnic Health Disparities |
| ISSN: | 2196-8837 2197-3792 |
| DOI: | 10.1007/s40615-021-01065-w |
| Popis: | The purpose of this study was to examine relationships among caregiver social support, caregiver depressive symptoms, medication adherence, and asthma control in a sample of low-income, urban, Black children aged 3–12 years with uncontrolled asthma and their caregivers. Using longitudinal data from a randomized controlled trial (RCT) assessing the efficacy of an environmental control educational intervention, we used generalized estimating equations and ordered logistic regression models to evaluate the relationship between caregiver social support (Medical Outcomes Study Social Support Survey), depressive symptoms (Center for Epidemiologic Studies Depression scale), and two child asthma outcomes: (a) medication adherence (Asthma Medication Ratio) and (b) asthma control. At baseline, 45.7% of the 208 children had very poorly controlled asthma. Nearly a third of caregivers (97% female) had clinically significant depressive symptoms at each data collection point. Social support was not associated with either asthma outcome nor did it moderate the relationship between depressive symptoms and child asthma outcomes. Higher caregiver depressive symptoms predicted decreased medication adherence (b=−0.003, SE 0.002). Moderate asthma at baseline (OR: 0.305, SE: 0.251), severe asthma at baseline (OR: 0.142, SE: 0.299), household income < $20,000 per year (OR: 0.505, SE: 0.333), and fall season (OR: 0.643, SE: 0.215) were associated with poorer asthma control. Attending to the social context of low-income, urban, Black children with asthma is critical to reduce asthma morbidity. Maternal depressive symptoms are modifiable and should be targeted in interventions to improve child asthma outcomes in this vulnerable population. The RCT was registered with ClinicalTrials.gov (NCT01981564) in October 2013. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink