How do ethnicity and primary language spoken at home affect management practices and outcomes in children and adolescents with asthma?
BACKGROUND
Lower rates of preventive medication use and higher rates of hospitalization and emergency department use have been documented among Latino children and adolescents with asthma. However, little is known about how language barriers influence asthma management practices and outcomes.


OBJECTIVE
To examine the effects of language on asthma management practices and asthma-related outcomes.


METHODS
Cross-sectional survey of asthma management practices, perceived efficacy, asthma knowledge, family functioning, and health-related quality of life in 405 white non-Latino, African American non-Latino, and Latino children and adolescents from English- and Spanish-speaking homes.


RESULTS
Latino children and adolescents from Spanish-speaking homes had lower rates of goal setting and peak flow monitoring, poorer asthma knowledge, and greater negative family impact than white children and adolescents (P < .05 for all). Although Latino children and adolescents from English-speaking homes did worse than their non-Latino white peers, the decrements were modest and not statistically significant (P>.16 for all). Management practices and outcomes for non-Latino African American children and adolescents closely approximated those of white children and adolescents.


CONCLUSIONS
Language barriers seem to contribute to poorer asthma management practices and knowledge among Latino children and adolescents. Efforts to increase knowledge in this group may enhance asthma self-care and limit the morbidity associated with asthma.
Chan
Kitty S
KS
Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA. kchan@jhsph.edu
Keeler
Emmett
E
Schonlau
Matthias
M
Rosen
Mayde
M
Mangione-Smith
Rita
R
D000293:Adolescent; D001249:Asthma / Q000208:ethnology* / Q000503:physiopathology / Q000517:prevention & control*; D002648:Child; D003144:Communication Barriers; D003430:Cross-Sectional Studies; D004522:Educational Status; D005195:Family Relations; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007802:Language; D008297:Male; D010290:Parents; D010366:Peak Expiratory Flow Rate / Q000502:physiology; D011788:Quality of Life; D044469:Racial Groups; D020377:Self Efficacy; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014481:United States