title: Cognitive-behavioral predictors of asthma morbidity in inner-city children.
abstract: Asthma is a growing health problem among children in the United States, particularly in urban, inner-city areas. This article examines the relationship between cognitive-behavioral aspects of asthma management (caretaker asthma knowledge, expectations, and problem-solving) and asthma morbidity in a sample of 1,376 inner-city children with physician-diagnosed asthma. In the analyses, baseline symptom severity served as a covariate, and the average of the 3-, 6-, and 9-month follow-up data served as the outcome measure. Children of caregivers with ineffective problem-solving strategies had significantly more days of wheezing over a 14-day period. Ineffective problem-solving capabilities were also associated with poorer functional status; however, positive caregiver expectations were associated with better functional status. Of the cognitive-behavioral factors studied in a high-risk urban population, caregiver problem-solving skills and expectations emerged as meriting further investigation and possible intervention.
authors.affiliation: Department of Pediatric Rehabilitation, Children's Hospital Medical Center, Cincinnati, Ohio 45229-3039, USA.
authors.forename: S L
authors.initials: SL
authors.lastname: Wade
authors.forename: G
authors.initials: G
authors.lastname: Holden
authors.forename: H
authors.initials: H
authors.lastname: Lynn
authors.forename: H
authors.initials: H
authors.lastname: Mitchell
authors.forename: C
authors.initials: C
authors.lastname: Ewart
mesh_terms: D001249:Asthma / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy*; D017028:Caregivers / Q000523:psychology*; D002648:Child; D002675:Child, Preschool; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D011340:Problem Solving; D012044:Regression Analysis; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D014505:Urban Population