Identifying Risk and Resource Factors in Children with Asthma from Urban Settings: The Context-Health-Development Model

Abstract

This two-year longitudinal study examined concurrent and across-time associations between characteristics related to context, health, and development (i.e., neighborhood disadvantage, knowledge related to asthma management and asthma management behaviors, and self-competence) and children's asthma-related functioning. Thirty-one 8- to 12-year-old children with asthma and their primary caregivers were interviewed for the baseline of this study, and 29 of these dyads were interviewed for the 1-year follow-up. All participants resided in urban neighborhoods, and most were members of ethnic minority (African American and Hispanic) groups. Cross-sectional support was found for significant inverse relationships between neighborhood disadvantage and children's asthma knowledge. Lower levels of self-competence were consistently cross-sectionally associated with lower levels of asthma knowledge. A combination of higher levels of asthma knowledge, more optimal asthma management strategies, and self-competence was associated with fewer school absences across the study period. These results suggest an interdependence between aspects of children's sociocultural context, health, and developmental characteristics. This multidimensional model provided preliminary support for the risk function of neighborhood disadvantage and the resource functions of asthma knowledge, asthma management, and self-competence for asthma-related functioning among urban children.