An Examination of Life Stressors Experienced by Families of Children with Asthma In Low-Income Communities of Color.

Asthma;Community Health Worker;Life Stressors;Social Support;Public Health;Social Sciences;Health Behavior & Health Education

Chung Densen, Lynna K.Janz, Nancy K. ;

University of Michigan

关键词: Asthma;    Community Health Worker;    Life Stressors;    Social Support;    Public Health;    Social Sciences;    Health Behavior & Health Education;   

Others  :  https://deepblue.lib.umich.edu/bitstream/handle/2027.42/95973/lchung_1.pdf?sequence=1&isAllowed=y

瑞士|英语

来源: The Illinois Digital Environment for Access to Learning and Scholarship

【 摘 要 】

This dissertation identified and explored life stressors impacting families of children with asthma and the characteristics and strategies of community health workers (CHWs) who mitigate these stressors through three separate studies: (i) a qualitative analysis of handwritten notes of CHWs who conducted home visits with families of children with asthma in Detroit, Michigan, during a household intervention study (n=115), (ii) in-depth interviews with CHWs from four asthma programs in diverse geographic regions in the U.S. (n=13), and (iii) a mixed-methods approach, in which the stressors identified in the first study were conceptualized into domains and tested using multivariate regression to determine their association with asthma-related health and quality of life (QOL) outcomes, and social support.CHWs described families’ struggles to obtain basic needs and amenities, including decent housing and employment.Oftentimes, assistive resources were ;;here today, gone tomorrow”.Outside of more tangible stressors, CHWs noted families’ interpersonal problems both within and outside the family.Many families were also balancing diverse health issues, which sometimes necessitated prioritizing one family member’s health over another’s.To address these stressors, CHWs established trust and built rapport with families.CHWs expressed the importance of showing care and compassion, exhibiting good listening skills, and being respectful of families’ circumstances.CHWs were dedicated and often assisted by intervening on behalf of families.Yet, some CHWs also recognized the need to move families towards independence.Regression analyses demonstrated the importance of examining the individual contributions of stressors domains on select asthma-related outcomes.While caregiver-related outcomes (i.e., depressive symptoms, caregiver pediatric asthma-related QOL) were associated with Basic and Work stressors, child outcomes (i.e., asthma symptoms and severity) were linked to Family Relationships and Family Health.Social support was shown to modify the relationship between Basic stressors and ER visits, as well as caregiver QOL. This study contributes a better understanding of the larger environmental, social, and psychosocial life stressors that may impede adequate asthma control and management, effective characteristics of CHWs and their strategies for intervening to assist families of children with asthma, and specific stressors important for intervention to improve asthma-related health and QOL.