title: Maternal psychological distress mediates the relationship between asthma and physician visits in a population-based sample of adolescents.
abstract: OBJECTIVE
  This study examined whether maternal psychological distress mediates the relationship between presence of adolescent asthma and number of physician visits and whether the association between maternal psychological distress and physician visits is moderated by adolescent general health.
  
  
  METHODS
  Data were obtained from the Mater University Study of Pregnancy and included 4025 adolescents. Path analysis was used to examine mediating and moderating effects.
  
  
  RESULTS
  Maternal psychological distress was found to partially mediate the relationship between adolescent asthma and number of physician visits, accounting for 25% of the effect of adolescent asthma on physician visits (p = 0.046). There was no evidence to suggest that adolescent general health moderated the association between maternal psychological distress and physician visits (p = 0.093).
  
  
  CONCLUSIONS
  These findings suggest that maternal psychological distress is associated with increased physician visits, regardless of adolescents' general health. Lowering maternal psychological distress may serve to reduce health care utilization and costs among adolescents with asthma.
authors.affiliation: Department of Psychiatry & Behavioral Neurosciences, McMaster University , Ontario , Canada .
authors.forename: Mark A
authors.initials: MA
authors.lastname: Ferro
authors.forename: Michael H
authors.initials: MH
authors.lastname: Boyle
authors.forename: Rosa
authors.initials: R
authors.lastname: Alati
authors.forename: James G
authors.initials: JG
authors.lastname: Scott
authors.forename: Kaeleen
authors.initials: K
authors.lastname: Dingle
mesh_terms: D000293:Adolescent; D001249:Asthma / Q000628:therapy*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D009035:Mothers / Q000523:psychology*; D009819:Office Visits / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000523:psychology*
keywords: Health service utilization; mediation; moderation; path analysis; statistical modeling