1. CONGRUENCE OF PARENT AND PRETEEN REPORTS OF THE PRETEENS’ EXPERIENCE WITH ASTHMA
N.M. CLARK, Ph.D., J.A. DODGE, M.S., R.H. ROBERTS, M.S., D.F. AWAD, M.A., L.J. THOMAS, M.P.H., S. SHAH, M.D., C.L.M. JOSEPH, Ph.D., M. VALERIO, M.P.H.
UNIVERSITY OF MICHIGAN, ANN ARBOR, MICHIGAN, UNITED STATES AND WESTMEAD HOSPITAL, SYDNEY, NEW SOUTH WALES, AUSTRALIA
INTRODUCTION RESULTS ADDITIONAL FINDINGS
Many asthma studies rely on parents' reports to assess the impact of asthma on a child. As children Diagnosed Ever by Physician Prescription Use by Nighttime Asthma Severity
reach the preteen years, they may be less available or willing to provide information to a parent
Children with a Diagnosis of Asthma
regarding their day-to-day experiences with the disease. This study of primarily 456 low income, Parent Predicting Child's Response
minority children (aged 10 to 13 years) and their primary caregivers compared their reports of
CHILD PARENT Overall Intermittent Asthma Persistent Asthma
asthma problems experienced at school. Cases were identified from a health screener indicating the Problems at School with. . . % Yes % Yes p-value Agreement Sensitivity Specificity
presence of asthma symptoms in the last 12 months.
Taking medicine 19.0% 16.4% 0.46 71.6% 18.2% 84.0% Anti-inflammatory AND Bronchodilator
Leaving class to take medicine 30.4% 16.5% <0.0001 71.3% 30.0% 89.4%
Bronchodilator only
METHODOLOGY Leaving class when feeling sick 61.2% 37.0% <0.0001 50.9% 40.1% 67.9%
Anti-inflammatory only
Teacher not wanting to give
8.8% 19.9% <0.001 75.7% 25.0% 80.6%
medicines
Preteen data were collected by trained interviewers who conducted face-to-face interviews with the No Prescription Medication
students at school. Data from the parent/guardians were collected using telephone interviews. Too many absences 36.8% 19.5% <0.0001 68.2% 33.3% 88.6%
Overall measures of agreement were computed and specificity and sensitivity were determined 0% 10% 20% 30% 40% 50% 60%
using the preteen's response as the reference. Comparisons in the frequency of positive responses Definitions
Symptomatic, But No Reported Diagnosis Intermittent Asthma = Nighttime symptoms no more than two times per month
reported by preteen and parent were made using McNemar's test. All p-values are two sided. Persistent Asthma = Nighttime symptoms more than two times per month
Parent Predicting Child's Response
CHILD PARENT Overall
Problems at School with. . . % Yes % Yes p-value Agreement Sensitivity Specificity
Reports of preteens in our sample with asthma:
DESCRIPTION OF THE SAMPLE POPULATION (N = 456) Taking medicine 9.2% 1.3% 0.03 89.5% 0.0% 98.6% Related to Asthma Medication at School: Related to Other School Experiences:
• 23% of preteens with asthma take asthma • There are no differences by asthma severity or
Leaving class to take medicine 12.0% 0.0% 0.003 88.0% 0.0% 100.0% medication at school. gender in terms of feelings about school or
Gender Race
• 85% of these preteens carry the medication experiences with peers.
3% Leaving class when feeling sick 54.1% 23.9% <0.0001 45.9% 22.1% 74.0%
9% with them at school as opposed to keeping it in • Overall 42% of preteens with asthma ever choose
1% African-
American/Black
Teacher not wanting to give the office or with other school personnel. not to play sports because of their asthma.
7.4% 8.6% 0.78 84.0% 0.0% 90.7%
1% medicines • A small percent (13%) of preteens report that • Overall 12% of preteens with asthma choose not to
Caucasian/White
Too many absences 27.7% 12.6% <0.001 71.1% 20.5% 90.4% it is sometimes hard to take medication at play sports most of the time because of their
48% Male Hispanic/Latino school. asthma.
52%
Female • Significantly more preteens with persistent
Multi-racial
asthma choose not to play sports most of the time
Unknow n compared to students with intermittent asthma
86% Overall, 63% of parents reported that their child had ever had a diagnosis of asthma. Diagnosed (15% vs. 9%, p = .05).
children and their parent/guardians reported more problems at school than did the non-diagnosed
Age Income children. However, across both sub-groups the pattern was the same with preteens consistently
4%
reporting more problems at school than their parents related to: taking medicines, needing to leave CONCLUSIONS
0% 7%
14%
6%
<$10 K
class to use medicine, leaving class when feeling sick, and too many school absences. Preteens
3%
10 4% 30% $10-20 K reported fewer problems than their parents regarding a teacher not wanting to give medicines. Overall preteens reported more problems with asthma at school than did their parent/guardians.
17%
11 5% $20-30 K
Agreement between preteens and parents was considerably lower in the presence of asthma
12 $30-40 K
$40-50 K
problems. Studies with preteens should make a special effort to collect data from the preteens
13 9%
14 $50-60 K themselves.
Unknow n $60+ K printed by
15% Unknow n
24% www.postersession.com
62%