title: Parental asthma education and risks for nonadherence to pediatric asthma treatments.
abstract: OBJECTIVE
  Targeted parental education reduces acute visits for pediatric asthma. Whether the use of education sources readily available to parents relates to nonadherence to asthma treatments is uncertain. This study describes asthma education sources and assesses for a relationship to risks for nonadherence.
  
  
  METHODS
  Caregivers of children with asthma completed a cross-sectional survey at 2 sites: a pediatric emergency department (ED) and an asthma clinic (AC). Measured items included the use of 7 education sources (primary care, ED, AC, friends/family, TV, internet, and printed materials), scores of child asthma morbidity, parental asthma knowledge, and risks for nonadherence, the primary outcome. Recruitment site, preferred language (English/Spanish), and demographics were recorded. Descriptive statistics, bivariate analyses, and multivariate regressions were performed.
  
  
  RESULTS
  A total of 260 participants, 158 from ED and 102 from AC, used a variety of education sources. They reported 4.1 (2.0) of 13 risk factors for nonadherence, with more risks in ED parents than AC parents (4.8 vs 3.9, P < 0.001). The ED parents worried more about medications and had worse access to primary care. The regression did not show a significant relationship between education sources and risks for nonadherence, but ED recruitment, Spanish language, and worse morbidity contributed to higher risks.
  
  
  CONCLUSIONS
  The use of more asthma education sources was not associated with reduced risks for nonadherence. Of the education sources, a primary care provider may benefit ED parents, who also need refills and education about medications. Spanish-speaking parents report more risks for nonadherence, warranting further study of Spanish-language asthma education.
authors.affiliation: From the *Division of Pediatric Emergency Medicine, Children's Hospital of Philadelphia, Philadelphia, PA; †Departments of Pediatrics and Emergency Medicine, University of California San Francisco, San Francisco, CA; ‡Children's Hospital Oakland Research Institute; §Department of Emergency Medicine, Children's Hospital and Research Center Oakland, Oakland, CA; and ∥Division of Emergency Medicine, Department of Pediatrics, Emory Children's Center for Cystic Fibrosis and Airways Disease Research, Emory University School of Medicine, Atlanta, GA.
authors.forename: Eva M
authors.initials: EM
authors.lastname: Delgado
authors.forename: Christine S
authors.initials: CS
authors.lastname: Cho
authors.forename: Ginny
authors.initials: G
authors.lastname: Gildengorin
authors.forename: Sara A
authors.initials: SA
authors.lastname: Leibovich
authors.forename: Claudia R
authors.initials: CR
authors.lastname: Morris
mesh_terms: D000293:Adolescent; D001249:Asthma / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D010290:Parents / Q000193:education*; D012306:Risk; D011795:Surveys and Questionnaires; D016903:Drug Monitoring