Albert Einstein College of Medicine, Bronx, NY.
Albert Einstein College of Medicine, Bronx, NY; Children's Hospital at Montefiore, Bronx, NY.
Acad Pediatr. 2018 Apr;18(3):310-316. doi: 10.1016/j.acap.2017.12.011. Epub 2018 Jan 5.
Physical activity (PA) levels are low in today's youth and may even be lower in those with asthma. Barriers to PA have not been well studied in inner-city minority children with asthma. We conducted a qualitative study to characterize parental perceptions of barriers to PA and ways to improve PA levels in children with asthma.
We used the socioecologic model to inform development of our interview guide. Questions fell into 2 socioecologic model domains: interpersonal (parent, family) barriers and community (neighborhood, school) barriers. Qualitative semistructured interviews were conducted with 23 parents (21 mothers, 2 fathers) of inner-city children with asthma (aged 8-10 years) from 10 Bronx, New York, elementary schools. Sampling continued until thematic saturation was reached. Interviews were recorded, transcribed, and independently coded for common themes. Emerging themes were discussed and agreed on by investigators.
Three themes surrounding interpersonal barriers to PA emerged: 1) parental fear of exercise-induced asthma due to lack of child symptom awareness, 2) nonadherence and refusal to take medications, and 3) challenges with asthma management. Four themes around community barriers to PA emerged: 1) lack of trust in school management of asthma, 2) lack of school PA facilities, 3) unsafe neighborhoods, and 4) financial burden of PA.
A complex, multilevel set of barriers to PA exist in children with asthma. Addressing these barriers by involving stakeholders at the family, school, and community levels may improve PA levels in children with asthma.
当今青少年的身体活动(PA)水平较低,而哮喘患者的 PA 水平甚至可能更低。在患有哮喘的城市内少数民族儿童中,PA 的障碍因素尚未得到充分研究。我们进行了一项定性研究,以描述父母对 PA 障碍的看法以及提高哮喘儿童 PA 水平的方法。
我们使用社会生态学模型来为我们的访谈指南提供信息。问题分为两个社会生态学模型领域:人际(父母、家庭)障碍和社区(邻里、学校)障碍。我们对来自纽约布朗克斯 10 所小学的 23 名哮喘儿童(年龄 8-10 岁)的父母(21 名母亲,2 名父亲)进行了半结构式定性访谈。继续进行抽样,直到达到主题饱和。访谈进行了录音、转录,并由独立的编码人员对常见主题进行编码。研究人员讨论并达成了新兴主题的共识。
围绕 PA 的人际障碍出现了三个主题:1)父母由于缺乏对儿童症状的认识而担心运动诱发的哮喘,2)不遵守和拒绝服用药物,以及 3)哮喘管理方面的挑战。围绕 PA 的社区障碍出现了四个主题:1)对学校管理哮喘缺乏信任,2)缺乏学校 PA 设施,3)邻里不安全,以及 4)PA 的经济负担。
哮喘儿童存在一系列复杂的、多层次的 PA 障碍。通过让家庭、学校和社区各级利益相关者参与,解决这些障碍因素可能会提高哮喘儿童的 PA 水平。