Graduation Year

2007

Document Type

Dissertation

Degree

Ph.D.

Degree Granting Department

Nursing

Major Professor

Mary Evans, Ph.D.

Keywords

Barriers, Disparities, Healthcare, Education, Adherence

Abstract

The objective of this study was to determine the influence of child and caregiver characteristics on asthma outcomes in Hispanic children. Specific research objectives of the study were to: (1) to asses the relative influence of family characteristics, caregiver level of education, asthma severity, insurance status and acculturation, on asthma outcomes in Hispanic children; (2) to asses the direct and indirect influence of acculturation on asthma outcomes in Hispanic children, while controlling for other variables; (3) to determine the relative influence of familial characteristics, parental level of education, asthma severity, insurance status and acculturation, as they predict utilization of asthma services.

The Children's Health Survey for asthma, the abbreviated Multidimensional Acculturation Scale and components of the Children's Medicaid Managed Care Questionnaire were administered during a one time visit with Hispanic caregiver's of children with asthma in a primary care setting. The primary care setting was either a local pediatrician office in Hillsborough County or the local Hillsborough County Health Department. These facilities provide primary care for local residents of the county. The interviews were conducted to identify the relative influence of barriers to asthma outcomes in this at risk population. A sample of one hundred seventy eight caregivers of Hispanic children with asthma identified significant findings that have a profound effect on pediatric asthma outcomes. Findings suggest that factors such as caregiver age and asthma severity have a negative effect on asthma outcomes in Hispanic children.

This study found that advanced caregiver age was associated with poorer healthcare outcomes. Acculturation was not found to be significantly associated with asthma outcomes, directly or indirectly even with use of service utilization as a mediator. In this subject sample the level of acculturation of the caregiver does not impact health care outcomes of the child. This study showed that asthma severity and acculturation significantly impacted service utilization. Children with higher asthma severity scores were found to utilize more services. Finally, acculturation was found to have a significant impact on service utilization. The more acculturated caregivers utilized more services than less acculturated caregivers.

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