title: Medication adherence among Latino and non-Latino white children with asthma.
abstract: OBJECTIVE
  Latino children of Caribbean descent remain at high risk for poorly controlled asthma. Controller medications improve asthma control; however, medication adherence remains suboptimal, particularly among minorities. This study assessed socioeconomic, family-based, and parent factors in medication adherence among children with asthma from Rhode Island (RI; Latino and non-Latino white [NLW]) and Puerto Rico.
  
  
  METHODS
  Data collection occurred as part of a multicenter study of asthma disparities. Our sample included children (ages 7-16) prescribed objectively monitored controller medications (n = 277; 80 island Puerto Rico, 114 RI Latino, 83 RI NLW). Parents completed questionnaires regarding family background and beliefs about medications. Families participated in an interview regarding asthma management. Multilevel analyses (maximum likelihood estimates) accounting for children being nested within site and ethnic group assessed the contribution of social context, family, and parent variables to medication adherence.
  
  
  RESULTS
  Medication adherence differed by ethnic group (F(2, 271) = 7.46, P < .01), with NLW families demonstrating the highest levels of adherence. Multilevel models indicated that parental beliefs about medication necessity and family organization regarding medication use were significant predictors of adherence, even for families below the poverty threshold. With family factors in the model, a substantial improvement in model fit occurred (Akaike Information Criterion change of 103.45).
  
  
  CONCLUSIONS
  Adherence to controller medications was lower among Latino children in our sample. Targeted interventions that capitalize on existing family resources, emphasize structure, and address parental beliefs about the importance of medications may be of benefit to families from different cultural backgrounds.
authors.affiliation: Bradley/Hasbro Children's Research Center, 1 Hoppin St, Providence, RI 02903, USA. elizabeth_mcquaid@brown.edu
authors.forename: Elizabeth L
authors.initials: EL
authors.lastname: McQuaid
authors.forename: Robin S
authors.initials: RS
authors.lastname: Everhart
authors.forename: Ronald
authors.initials: R
authors.lastname: Seifer
authors.forename: Sheryl J
authors.initials: SJ
authors.lastname: Kopel
authors.forename: Daphne Koinis
authors.initials: DK
authors.lastname: Mitchell
authors.forename: Robert B
authors.initials: RB
authors.lastname: Klein
authors.forename: Cynthia A
authors.initials: CA
authors.lastname: Esteban
authors.forename: Gregory K
authors.initials: GK
authors.lastname: Fritz
authors.forename: Glorisa
authors.initials: G
authors.lastname: Canino
mesh_terms: D000293:Adolescent; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy* / Q000208:ethnology*; D002648:Child; D005260:Female; D006630:Hispanic or Latino / Q000208:ethnology*; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000208:ethnology*; D011647:Puerto Rico / Q000208:ethnology; D012237:Rhode Island / Q000208:ethnology; D044465:White People / Q000208:ethnology
chemical_list: D018927:Anti-Asthmatic Agents