Differences in Environmental Control and Asthma Outcomes Among Urban Latino, African American, and Non–Latino White Families

Everhart, Robin S.; Kopel, Sheryl J.; McQuaid, Elizabeth L.; Salcedo, Leslie; York, Daniel; Potter, Christina; Koinis-Mitchell, Daphne

doi:10.1089/ped.2011.0081

Cited by 20 publications

(16 citation statements)

References 18 publications

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“…The FAMSS has been used in cross sectional and treatment outcome studies and has been validated with minority samples 60 and in English and Spanish. 61 Internal consistency has been very good in prior studies (Cronbach’s α = .84) 62 and in the current sample (Cronbach’s α = .76).…”

Section: Participant and Methodssupporting

confidence: 51%

Asthma-related lung function, sleep quality, and sleep duration in urban children

et al. 2017

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Objectives Examine 1) the extent to which changes in objectively measured asthma-related lung function (FEV1 % predicted) within a sleep period are associated with sleep quality and sleep duration during that sleep period, in a group of urban children with persistent asthma; and 2) associations between morning and evening asthma-related lung function and sleep quality and duration on the adjacent night, and 3) whether these associations differ by ethnic group. Design Cross-sectional, multi-method approach. Children completed a clinic assessment of asthma and allergy status and used home-based objective measurements of asthma-related lung function and sleep. Setting Children and their caregivers participated in a clinic assessment at an asthma and allergy clinic and completed additional assessments at home. Participants Two hundred and sixteen African American, Latino, and non-Latino white urban children, ages 7–9 years, and their primary caregivers. Measurements Participants took part in a clinic assessment of asthma and allergy status, completed interview-based questionnaires including a diary to track asthma symptoms and sleep patterns, and used actigraphy and home-based spirometry daily across a 4-week period to assess sleep and lung function. Results and Conclusions Results from analyses using structural equation modeling revealed an association between worsening FEV1 and poor sleep quality in the full sample, as well as better asthma-related lung function at night and more optimal sleep efficiency that night. Ethnic group differences emerged in the association with morning or nighttime lung function measurements and sleep quality. Urban minority children with asthma may be at heightened risk for poorer quality sleep. Timing of lung function worsening may be important when considering when and how to improve both asthma health outcomes and sleep quality within specific groups.

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Section: Participant and Methodssupporting

confidence: 51%

Asthma-related lung function, sleep quality, and sleep duration in urban children

et al. 2017

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“…Some studies suggest a genetic link between the incidence and prevalence of asthma and African American race (Smith et al, 2008; Flores et al, 2012), while others reported that life style and home environment may be the source of ethnic disparities (Sun and Sundell, 2011). Another explanation for the high prevalence of asthma among African Americans is that they are more likely to live in older urban homes in the U.S. (Aligne et al, 2000; Everhart et al, 2011). Families with lower income may have higher concentrations of indoor contaminants because poverty causes them to live in more deteriorating structures as those with higher income.…”

Section: Discussionmentioning

confidence: 99%

Family and home characteristics correlate with mold in homes

Reponen

Levin

Zheng

et al. 2013

Environmental Research

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Previously, we demonstrated that infants residing in homes with higher Environmental Relative Moldiness Index were at greater risk for developing asthma by age seven. The purpose of this analysis was to identify the family and home characteristics associated with higher moldiness index values in infants' homes at age one. Univariate linear regression of each characteristic determined that family factors associated with moldiness index were race and income. Home characteristics associated with the moldiness index values were: air conditioning, carpet, age of the home, season of home assessment, and house dust mite allergen. Parental history of asthma, use of dehumidifier, visible mold, dog and cat allergen levels were not associated with moldiness index. Results of multiple linear regression showed that older homes had 2.9 units higher moldiness index (95% confidence interval [CI] = 0.4, 5.4), whereas homes with central air conditioning had 2.5 units lower moldiness index (95% CI = -4.7, -0.4). In addition, higher dust mite allergen levels and carpeting were positively and negatively associated with higher moldiness index, respectively. Because older homes and lack of air conditioning were also correlated with race and lower income, whereas carpeting was associated with newer homes, the multivariate analyses suggests that lower overall socioeconomic position is associated with higher moldiness index values. This may lead to increased asthma risk in homes inhabited by susceptible, vulnerable population subgroups. Further, age of the home was a surrogate of income, race and carpeting in our population; thus the use of these factors should carefully be evaluated in future studies.

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“…Adherence to asthma medication at study entry was also queried using a 5-point Likert scale: 1 = never to almost never missed, 2 = occasionally missed, 3 = missed about half the time, 4 = missed more than half the time, to 5 = missed almost all the time. 18,19 Caregiver perception of allergy status Before allergy skin prick testing, caregivers were asked questions about their child's nasal symptoms: (1) Do you think your child has allergies, and (2) has your doctor ever told you or diagnosed your child with allergies? Caregivers were asked whether their child ever had allergy testing before the research clinic visit.…”

Section: 15mentioning

confidence: 99%

Underdiagnosed and Undertreated Allergic Rhinitis in Urban School-Aged Children with Asthma

Esteban

Klein

Kopel

et al. 2014

Pediatric Allergy, Immunology, and Pulmonology

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Allergic rhinitis (AR) is a risk factor for the development of asthma, and if poorly controlled, it may exacerbate asthma. We sought to describe AR symptoms and treatment in a larger study about asthma, sleep, and school performance. We examined the proportion (1) who met criteria for AR in an urban sample of school children with persistent asthma symptoms, (2) whose caregivers stated that they were not told of their child's allergies, (3) who had AR but were not treated or were undertreated for the disease, as well as (4) caregivers and healthcare providers' perceptions of the child's allergy status compared with study assessment, and (5) associations between self-report of asthma and AR control over a 4-week monitoring period. One hundred sixty-six children with persistent asthma participated in a clinical evaluation of asthma and rhinitis, including allergy testing. Self-report of asthma control and rhinitis control using the Childhood Asthma Control Test (C-ACT) and Rhinitis Control Assessment Test (RCAT) were measured 1 month after the study clinic session. Persistent rhinitis symptoms were reported by 72% of participants; 54% of rhinitis symptoms were moderate in severity, though only 33% of the sample received adequate treatment. AR was newly diagnosed for 53% during the clinic evaluation. Only 15% reported using intranasal steroids. Participants with poorly controlled AR had poorer asthma control compared with those with well-controlled AR. This sample of urban school-aged children with persistent asthma had underdiagnosed and undertreated AR. Healthcare providers and caregivers in urban settings need additional education about the role of allergies in asthma, recognition of AR symptoms, and AR's essential function in the comanagement of asthma. Barriers to linkages with allergy specialists need to be identified.

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Differences in Environmental Control and Asthma Outcomes Among Urban Latino, African American, and Non–Latino White Families

Cited by 20 publications

References 18 publications

Asthma-related lung function, sleep quality, and sleep duration in urban children

Asthma-related lung function, sleep quality, and sleep duration in urban children

Family and home characteristics correlate with mold in homes

Underdiagnosed and Undertreated Allergic Rhinitis in Urban School-Aged Children with Asthma

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