Problem-solving skills training for vulnerable families of children with persistent asthma: report of a randomized trial on health-related quality of life outcomes.
OBJECTIVE
To test the efficacy of problem-solving skill training (PST) in improving health-related quality of life (HRQOL) of children with persistent asthma from predominantly lower socioeconomic status (SES) Spanish-speaking Hispanic families.


METHODS
Randomized controlled trial comparing standard care waitlist (SC) control, home-visiting asthma education/care coordination (CC), and combined intervention (CC + PST) at baseline, after intervention, and 6-month follow-up. The primary outcome was parent proxy-report child HRQOL (PedsQL).


RESULTS
Participants (n = 252) were 83.3% Hispanic and 56.3% monolingual Spanish speakers, and 72.6% of mothers had not graduated high school. We found a significant (P = 0.05) intervention effect for parent proxy-reported child generic (but not asthma-specific) HRQOL, with CC + PST superior to SC [83.8 vs 79.8; adjusted mean difference of 4.05 points (95% confidence interval 0.63-7.4], but no difference between the CC and SC groups.


CONCLUSIONS
In this sample of vulnerable families of children with persistent asthma, a CC + PST intervention was efficacious in improving children's generic HRQOL.
Seid
Michael
M
Division of Pulmonary Medicine, Cincinnati Children’s Hospital Medical Center, USA. michael.seid@cchmc.org
Varni
James W
JW
Gidwani
Pradeep
P
Gelhard
Leticia Reyes
LR
Slymen
Donald J
DJ
D000293:Adolescent; D001249:Asthma; D002140:California; D002648:Child; D002675:Child, Preschool; D005260:Female; D006266:Health Education; D006304:Health Status; D006630:Hispanic or Latino / Q000523:psychology; D006801:Humans; D008297:Male; D017057:Medically Uninsured; D016487:Parenting; D011340:Problem Solving; D011788:Quality of Life; D012044:Regression Analysis; D016037:Single-Blind Method