Asthma risk factor assessment: what are the needs of inner-city families?
BACKGROUND
A complex array of risk factors contributes to sustained high levels of asthma morbidity in inner-city children.


OBJECTIVE
To describe risk factors for asthma morbidity in a national sample of inner-city children with persistent asthma.


METHODS
This study examined baseline questionnaire results from 1,772 children ages 5 to 11 years old with moderate to severe persistent asthma who enrolled in the Centers for Disease Control and Prevention-funded Inner-City Asthma Intervention between April 2001 and March 2004. Risk for asthma morbidity was assessed in 9 domains using the Child Asthma Risk Assessment Tool. The domains included environmental exposures, parental stress, medication adherence, pessimistic asthma beliefs, smoke exposure, aeroallergen exposure, child psychological well-being, responsibility for medication administration, and medical care.


RESULTS
A total of 51% of families demonstrated high risk of asthma morbidity in 3 or more domains. High risk of asthma morbidity was suggested based on household environmental exposures (47.7%), high parental stress (38.5%), poor medication adherence (38.3%), pessimistic asthma beliefs (31.8%), environmental tobacco smoke (24.4%), sensitization to aeroallergens in the home (24.8%), child behavioral or emotional concerns (22.9%), child assigned responsibility for medication administration (21.2%), and poor medical care (20.7%). Allergy testing was completed for 40% of the participating children. Of these children, 61% were exposed to aeroallergens in their home to which they were sensitized.


CONCLUSIONS
In this national sample of inner-city children, multiple risk factors for asthma morbidity were identified. Asthma programs that provide multilevel support and intervention are needed to reduce the burden of asthma on inner-city families.
Warman
Karen
K
Department of Pediatrics, Children's Hospital at Montefiore/Albert Einstein College of Medicine, Bronx, New York 10461, USA. kwarman@montefiore.org
Silver
Ellen Johnson
EJ
Wood
Pamela R
PR
D016902:Air Pollution, Indoor / Q000009:adverse effects; D000485:Allergens / Q000276:immunology; D000818:Animals; D001249:Asthma / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology / Q000628:therapy; D001294:Attitude to Health; D002648:Child; D002675:Child, Preschool; D003469:Culture; D003695:Delivery of Health Care; D005260:Female; D006078:Government Programs / Q000458:organization & administration; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006798:Housing; D006801:Humans; D006967:Hypersensitivity / Q000150:complications / Q000175:diagnosis; D008297:Male; D010290:Parents / Q000523:psychology; D010349:Patient Compliance / Q000706:statistics & numerical data; D012307:Risk Factors; D013312:Stress, Physiological / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014028:Tobacco Smoke Pollution; D014481:United States / Q000453:epidemiology; D014504:Urban Health; D014505:Urban Population
D000485:Allergens; D014028:Tobacco Smoke Pollution