Managing children’s asthma: what role do caregivers’ mental representations of trigger and symptom management behaviors play?

Abstract

Objective

Pediatric asthma management is challenging for parents and guardians (hereafter caregivers). We examined (1) how caregivers mentally represent trigger and symptom management strategies, and (2) how those mental representations are associated with actual management behavior.

Methods

In an online survey, N = 431 caregivers of children with asthma rated 20 trigger management behaviors and 20 symptom management behaviors across 15 characteristics, and indicated how often they engaged in each behavior.

Results

Principal components analysis indicated 4 dimensions for trigger management behaviors and 3 for symptom management behaviors. Bayesian mixed-effects models indicated that engagement in trigger management behavior was more likely for behaviors rated as affirming caregiver activities. However, trigger management behavior did not depend on how highly the behavior was rated as challenging for caregiver, burdensome on child, or routine caregiving. Engagement in symptom management behavior was more likely for behaviors rated as affirming and common and harmless to the child, but was unrelated to how highly a behavior was rated as challenging for caregivers.

Conclusion

These results suggest that interventions might be particularly useful if they focus on the affirming nature of asthma management behaviors. However, such interventions should acknowledge structural factors (e.g. poverty) that constrain caregivers’ ability to act.

Keywords:

• Asthma
• parent
• child
• adolescent
• behavior

Disclosure statement

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Data availability, deposition, and sharing

The de-identified data, the analytic code used to conduct the analyses presented in this manuscript, and all materials used to conduct the study are freely available in the Open Science Framework public archive: https://osf.io/awqf8/. We do not submit them with this manuscript because the dataset includes data points that (a) are not relevant to this paper, and (b) are relevant to other manuscripts that will be submitted to other publication venues.

Data availability and sharing

The de-identified data, the analytic code used to conduct the analyses presented in this manuscript, and all materials used to conduct the study are freely available in the Open Science Framework public archive: https://osf.io/awqf8/?view_only=b965206c97684ab094e96e960826bf63

Additional information

Funding

This research was supported by the U.S. National Institutes of Health (R01HL137680, Principal Investigators Erika A. Waters, James Shepperd).