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Puerto Rican children experience the highest asthma prevalence, morbidity and mortality rates of any racial/ethnic group and these rates are increasing.1-6 In Chicago, a community health survey yielded physician diagnosed asthma rates of 21% in Puerto Rican children, compared to 9% in Mexican children, 16% in black children and 12% in white children. Many children screened positive for asthma symptoms, even though they had not received a physician diagnosis of asthma. This resulted in potential total asthma rates of 34% in Puerto Rican children, 14% in Mexican children, 25% in black children and 20% in white children.7 Lara, et al, attributed these rates in Puerto Rican children to “an ethnic group-specific genetic disposition among Puerto Rican children that interacts with early life physical and social environmental exposures.”8 The literature describes specific social and cultural variables that influence asthma self-management behaviors in Puerto Rican.9-14
We are currently performing a qualitative study to inform the design of an intervention that will target asthma self-management behaviors for Puerto Rican families. In this qualitative study, key informant interviews are used to determine what types of asthma self-management behaviors are typically done by children, what types are done by their caregivers, and how this varies with age in Puerto Rican children with asthma and their caregivers. Focus groups are used to identify ways to appropriately address and incorporate social and cultural influences of asthma self-management into an asthma self-management educational intervention for Puerto Rican families.
For more information, contact Molly Martin at (312) 942-2540 or molly_a_martin@rush.edu.
Principal Investigator:
Molly Martin, MD, MAPP
Co-Investigator:
Steven Whitman, PhD
Community Partner:
Puerto Rican Cultural Center
1. Lara M, Akinbami L, Flores G, Morgenstern H. Heterogeneity of childhood asthma among Hispanic children: PR children bear a disproportionate burden. Pediatrics 2006:117:43-53.
2. Thomas SD, Whitman S. Asthma hospitalizations and mortality in Chicago. Chest 1999; 116:135-141S.
3. Trends in Asthma Morbidity and Mortality. American Lung Association. Epidemiology and Statistics Unit. April 2004. http://www.lungusa.org/atf/cf/(Martin M and SK)/ASTHMA1.PDF, accessed 6/2/04.
4. Centers for Disease Control and Prevention. Surveillance for Asthma--United States, 1980-1999. MMWR 2002;51(No. SS-1):1-13.
5. Centers for Disease Control and Prevention. Asthma prevalence and control characteristics by race/ethnicity--United States, 2002. MMWR 2004;53:145-148.
6. Homa DM, Mannino DM, Lara M. Asthma mortality in US Hispanics of Mexican, Puerto Rican, and Cuban heritage, 1990-1995. American Journal of Respiratory and Critical Care Medicine 2000;161:504-509.
7. Whitman S, Williams C, Shah A. Sinai Health System’s Community Health Survey: Report 1. Chicago, Illinois: Sinai Health System, 2004.
8. Lara M, Morgenstern H, Duan N, Brook RH. Elevated asthma morbidity in Puerto Rican children: A review of possible risk and prognostic factors. Western Journal of Medicine 1999;170:75-84.
9. Beckett WS, Belanger K, Gent JF, Holford TR, Leaderer BP. Asthma among Puerto Rican Hispanics: a multi-ethnic comparison study of risk factors. American Journal of Respiratory and Critical Care Medicine 1996;154:894-9.
10. Pachter LM, Weller SC. Acculturation and compliance with medical therapy. Journal of Developmental and Behavioral Pediatrics 1993;14:163-168.
11. Tumiel-Berhalter L, Zayas LU. Lay experiences and concerns with asthma in an urban Hispanic community. Journal of the National Medical Association 2006;98:875-880.
12. Pachter LM, Weller SC, Baer RD, Garcia de Alba Garcia JE, Trotter II RT, Glazer M, Klein R. Variation in asthma beliefs and practices among mainland Puerto Ricans, Mexican-Americans, Mexicans, and Guatemalans. Journal of Asthma 2002;39:119-134.
13. Ledoger R, Penchaszadeh A, Garden CCI, Acosta LG. Asthma and Latino cultures: different prevalence reported among groups sharing the same environment. American Journal of Public Health June 2000; 90(6):929-935.
14. Braganza S, Ozuah PO, Sharif I. The use of complementary therapies in inner-city asthmatic children. Journal of Asthma 2003;40:823-827.
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