Influence of social support on asthma self-management in adolescents

Abstract

Objective

Adolescents with asthma are influenced by peers and family. The objective was to better understand family social support and test its association with medication adherence, asthma control, and Emergency Department (ED) use.

Methods

This study is a cross-sectional secondary data analysis from a randomized controlled trial with urban adolescents from three U.S. cities. Participants (12-20 years old) with asthma completed the Perceived Family Support Scale (PFS) and Horne’s Medication Adherence Report Scale (MARS). Data from both tools were classified into 2 categories- high and low (< 25^th percentile) perceived family support and high (total score >10) and low medication adherence, respectively. Chi-square statistic and logistic regression were used for analysis.

Results

Of the 371 participants, the majority were young (96% ≤ 17 years), African American or Bi-racial (85%), and Medicaid-insured (72%); over one-third had maternal family history of asthma. Among those on a controller medication (n = 270), only 37% reported its use ≥8 days over 2 weeks. Asthma control was poor with 50% categorized “not well controlled,” 34% “very poorly controlled.” Participants responded positively to most social support items. One item, providing and receiving social support to and from family members, was less often positively reported. Low medication adherence was significantly associated with lower perceived social support (p = 0.018).

Conclusion

This study underscores the importance of family social support in understanding the extent of adolescents’ self-management, particularly medication adherence.

Keywords:

• Asthma
• adolescents
• self-management
• social support
• family social support
• medication adherence
• asthma control
• urban adolescents

Acknowledgements

The authors wish to thank Annette Grape who made important contributions to managing and directing the PLASMA project, and to Curtis Roby for editing this manuscript. We also thank our research assistants Danielle Abramo, Angela Cardena, Caroline Horrigan, Shawn Davis, Jennifer Dolgoff, Dr. Rice, Karen Edwards, Cassie Land, and Vern Brown. Finally, we thank the teens and families for their participation in the study and the peer leaders for their dedication to the project.

Disclosure statement

None of the authors have any conflicts of interest related to this paper, the project, or the funders.

Funding

This work was supported the National Institute of Health/National Institute for Nursing Research (Grant number: 5R01NR014451-05).

Data availability

Data is available on request.

Additional information

Funding

This paper is based on a study funded by the National Institute for Nursing Research under grant: R01 NR014451 awarded to Dr. Hyekyun Rhee from 2014 to 2019.