Family support and asthma outcomes in adolescents: barriers to adherence as a mediator.
OBJECTIVE
Asthma morbidity in children is associated with family psychosocial functioning. Although the family plays a pivotal role in maintaining optimal asthma care, the mechanism of how family support influences asthma outcomes is not well understood. The purpose of this study was to examine the role of barriers to adherence in mediating the effect of family support on asthma outcomes in adolescents.


METHODS
The sample included 126 adolescents with asthma aged 13-20 years, living in the Northeast United States. The sample consisted of 49% Whites and 51% minorities, including primarily Blacks (38%) followed by Hispanic (11%). Adolescents provided self-reported data. Structural equation modeling was performed to examine the direct and indirect relationships between family support and asthma outcomes.


RESULTS
Family support was positively associated with asthma control and quality of life. These significant associations were mediated by barriers to adherence. Particularly, family support was found to reduce barriers concerning adolescents' negative attitudes toward medication and healthcare providers, which in turn improved asthma control and quality of life symptoms, emotional functioning, and activity domains. Adolescents' cognitive difficulty also tended to mediate the relationship between family support and emotional functioning.


CONCLUSIONS
This study highlights the beneficial effects of family support in improving asthma outcomes in adolescents. Family support exerts the positive effect by ameliorating barriers to treatment adherence in adolescents, particularly the barriers associated with negative attitudes and cognitive challenges. The findings underscore the importance of incorporating family assessment and intervention in caring for adolescents with asthma.
Rhee
Hyekyun
H
University of Rochester, School of Nursing, Rochester, New York 14642, USA. hyekyun_rhee@urmc.rochester.edu
Belyea
Michael J
MJ
Brasch
Judith
J
D000293:Adolescent; D001249:Asthma / Q000188:drug therapy*; D003430:Cross-Sectional Studies; D005190:Family; D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence; D009511:New England; D017063:Outcome Assessment, Health Care; D011788:Quality of Life; D012944:Social Support; D055815:Young Adult