Abstract

Background: Asthma is the primary chronic disease diagnosed in children. California has had some of the highest asthma prevalence rates within the nation. The literature indicates that there is a poor understanding of asthma outcome and management. However, studies exploring the role of acculturation on such outcomes are limited. Thus, the goal of this research was to conduct a secondary analysis of the Child Questionnaire from the California Health Interview Survey (CHIS) 2007 and 2009 cross-sectional data to explore the determinants of asthma outcomes as it relates to family acculturation.

Methodology: The quantitative data were analyzed using Stata. Descriptive statistics, univariate analyses, multivariable logistic regression analyses were used to evaluate whether family acculturation is associated with asthma outcomes, after adjusting for age (child and parent), gender (child and parent), socioeconomic status (family) and access to healthcare (child).

Results: An annual population estimate of 237,802 children reported having an asthma diagnosis by a doctor and among such a population, 98,908 had an asthma attack in the past 12 months. Among those diagnosed with asthma, an annual population estimate of 99,013 children reported lacking asthma management resource. Low family acculturation was associated with children's diagnosis of asthma (p < .005) but not asthma attack (p > .05) in bivariate analyses. In multivariate logistic regression models, low acculturation was associated with lower odds of asthma diagnosis (OR = 0.41,95% CI: 0.21, 0.79), and asthma attack in the last 12 months (OR = 0.40, 95% CI: 0.15,1.08), though the latter did not reach statistical significance. Low family acculturation was associated with families having asthma management plan (p < .005) in bivariate analyses. In multivariate logistic regression models, low acculturation (speaking only Spanish at home) was associated with lower odds of having asthma management plan from doctor (unadjusted OR = 0.33), though it did not reach statistical significance upon adjusting for covariates. Additional outcomes could not he explored due to limited sample size or non significant associations based on bivariate analyses. Though the latter did not reach statistical significance, low family acculturation was associated with families having asthma management plan (p < .005).

Conclusion: Latinos are consistently reported to have lower asthma rates in California and the nation and yet little is known about the reasons for such outcomes. Moreover, asthma management is key to lower the burden of asthma and little research exists on factors associated with asthma management. Results from this study showed that low family acculturation was associated with lower odds of asthma diagnosis among children and lower odds of having an asthma management plan. Such results should further help health education specialists promote traditional values that are protective against asthma while improve patient-physician communication to ensure at-risk populations gain access to necessary asthma management plans.

School

School of Public Health

First Advisor

Naomi Modeste

Second Advisor

Jim Banta

Third Advisor

Jerry Lee

Degree Name

Doctor of Public Health (DrPH)

Degree Level

Ph.D.

Year Degree Awarded

2013

Date (Title Page)

6-2013

Language

English

Library of Congress/MESH Subject Headings

Pediatric respiratory diseases; Asthma in children; Asthma in children -- Patients -- Family relations; Acculturation; Hispanic Americans; Hispanic American children; Respiratory Tract Diseases -- Child; Asthma -- Child; Asthma -- ethnology; Parent-Child Relations

Type

Dissertation

Page Count

ix; 75

Digital Format

PDF

Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.

Collection

Loma Linda University Electronic Theses and Dissertations

Collection Website

http://scholarsrepository.llu.edu/etd/

Repository

Loma Linda University. Del E. Webb Memorial Library. University Archives

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