Changes in caregiver mental health and pediatric asthma control during COVID-19

Abstract

Objective

This study evaluated caregivers’ stress and depressive symptoms, and children’s asthma control, before COVID-19 began and after its onset among families in the RVA Breathes program.

Methods

The RVA Breathes intervention, which took place in an urban city in the United States, includes asthma education delivered by a community health worker (CHW), a home assessment, and school nurse components. Participants included 125 children (5–11 years) with asthma and their caregivers (48% household income <$25,000) enrolled prior to the pandemic. Families were randomized to an active intervention arm (full intervention or intervention without school nurse component) or the control group. Caregivers completed the Center for Epidemiological Studies Depression Scale (CES-D) and the Perceived Stress Scale (PSS); children and caregivers completed the Childhood Asthma Control Test (cACT). Assessments pre-COVID-19 were compared to those completed after the pandemic’s onset.

Results

Children in both intervention groups had better cACT scores after the start of COVID-19 compared to before (t(55) = −2.131, p = .019; t(28) = −2.893, p = .004). Caregivers in the intervention groups had lower PSS scores after the start of COVID-19 compared to pre-COVID-19 (t(53) = 3.928, p < .001; t(28) = 2.568, p = .008). Furthermore, CES-D scores improved among caregivers in the full intervention (t(48) = 1.789, p = .040). Caregivers in the control condition did not report significant changes in stress or depressive symptoms.

Conclusions

Findings suggest that support from interventionists, including CHWs, might have alleviated stress and depressive symptoms during COVID-19, as well as improved asthma control during the pandemic.

Keywords:

• Pediatric asthma
• COVID-19
• caregiver mental health
• stress
• family
• disparities

Acknowledgements

The authors express gratitude for the families and youth with asthma who participated in RVA Breathes, as well as the RVA Breathes Community Health Workers, Healthy Homes Assessors, Richmond Public School nurses, and research team at Virginia Commonwealth University.

Declaration of interest

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

Additional information

Funding

This work was supported by funding from the National Heart, Lung, and Blood Institute (NHLBI) U01 HL138682 to the second author, and F31 HL158196 to the first author. The content is solely the responsibility of the authors and does not necessarily represent the official views of NHLBI.