Psychosocial characteristics of inner-city children with asthma: A description of the NCICAS psychosocial protocol

Shari Wade, Connie Weil, Gary Holden, Herman Mitchell, Richard Evans, Deanna Kruszon-Moran, Laurie Bauman, Ellen Crain, Peyton Eggleston, Meyer Kattan, Carolyn Kercsmar, Fred Leickly, Floyd Malveaux, H. James Wedner, Ernestine Smartt

Research output: Contribution to journalArticlepeer-review


Previous research has demonstrated a significant reciprocal relationship between psychosocial factors and asthma morbidity in children. The National Cooperative Inner-City Asthma Study investigated both asthma-specific and non-specific psychosocial variables, including asthma knowledge beliefs and management behavior, caregiver and child adjustment, life stress, and social support. This article presents these psychosocial characteristics in 1,528 4- 9-year-old asthmatic urban children and their caretakers. Caretakers demonstrated considerable asthma knowledge, averaging 84% correct responses on the Asthma Information Quiz. However, respondents provided less than one helpful response for each hypothetical problem situation involving asthma care, and most respondents had more than one undesirable response, indicating a potentially dangerous or maladaptive action. Both adults and children reported multiple caretakers responsible for asthma management (adult report: average 3.4, including the child); in addition, children rated their responsibility for self-care significantly higher than did adults. Scores on the Child Behavior Checklist indicated increased problems compared to normative samples (57.3 vs. 50, respectively), and 35% of children met the criteria for problems of clinical severity. On the Brief Symptom Inventory, adults reported elevated levels of psychological distress (56.02 vs norm of 50); 50% of caretakers had symptoms of clinical severity. Caretakers also experienced an average of 8.13 undesirable life events in the 12 months preceding the baseline interview. These findings suggest that limited asthma problem-solving skills, multiple asthma managers, child and adult adjustment problems, and high levels of life stress are significant concerns for this group and may place the inner-city children in this study population at increased risk for problems related to adherence to asthma management regimens and for asthma morbidity.

Original languageEnglish (US)
Pages (from-to)263-276
Number of pages14
JournalPediatric Pulmonology
Issue number4
StatePublished - Oct 1997


  • Asthma
  • Children
  • Inner-city
  • Psychosocial

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Pulmonary and Respiratory Medicine


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