Parental coping, depressive symptoms, and children's asthma control and school attendance in low-income, racially, and ethnically diverse urban families

ABSTRACT

Objective: Low-income urban children of color are at elevated risk for poor asthma control. This cross-sectional study examined associations among parents' coping (primary control, secondary control, and disengagement), parental depressive symptoms, and children's asthma outcomes (asthma control and school attendance) in a predominantly low-income, racially/ethnically diverse sample of families. Methods: Parents (N = 78; 90% female) of children (33% female; 46% Black; 38% Latino) aged 5–17 years (M = 9.5 years) reported on their own coping and depressive symptoms, their child's asthma control, and full and partial days of school missed due to asthma. Results: Parents' secondary control coping (i.e., coping efforts to accommodate/adapt to asthma-related stressors) was negatively correlated, and disengagement coping (i.e. coping efforts to avoid/detach from stressors) was positively correlated, with their depressive symptoms. Secondary control coping was also correlated with fewer partial days of school missed. Primary control coping (i.e., coping efforts to change stressors) was not associated with depressive symptoms or asthma outcomes. Parents' depressive symptoms were also positively correlated with poorer asthma control and partial days of school missed. Regression models showed direct and indirect effects of secondary control and disengagement coping on asthma outcomes via depressive symptoms, after controlling for demographic factors. Conclusions: Parents' secondary control and disengagement coping are related to children's asthma outcomes. Secondary control coping may support parents' mental health and children's asthma control in low-income urban families.

KEYWORDS:

• Asthma
• child
• coping
• depression
• low-income
• parent

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Funding

This work was supported by the National Institute of Mental Health (grant number T32MH067631) and a grant from the Society of Pediatric Psychology (Diversity Research Grant).

Notes

1 All measures were translated into Spanish, and Spanish versions were pretested and refined based on feedback of bilingual research staff. The demographic questionnaire and the Response to Stress Questionnaire were adapted from similar versions translated and backtranslated by the first author and other bilingual researchers using the iterative process described by Brislin [43]. The Spanish version of the asthma therapy assessment questionnaire is distributed by Merck & Company, Inc., and the Spanish version of the Beck Depression Inventory-II was previously translated and validated with Spanish-speaking participants [44].