Kornblit A, Cain A, Bauman LJ, Brown N, Reznik M. Acad. Pediatr. 2018; 18(3): 310-316.
Affiliation
Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY, 10461, USA; Children's Hospital at Montefiore, 3415 Bainbridge Avenue, Bronx, NY, 10467, USA. Electronic address: mreznik@montefiore.org.
OBJECTIVE: 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.
METHODS: We used the socio-ecological model (SEM) to inform development of our interview guide. Questions fell into two SEM domains: 1) interpersonal (parent, family) barriers and 2) community (neighborhood, school) barriers. Qualitative semi-structured interviews were conducted with 23 parents (21 mothers, 2 fathers) of inner-city children with asthma (ages 8-10 years) from 10 Bronx, New York (NY) 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 upon by investigators.
RESULTS: Three themes surrounding interpersonal barriers to PA emerged: 1) parental fear of exercise-induced asthma due to lack of child symptom awareness; 2) non-adherence 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.
CONCLUSIONS: Our results indicate a complex multi-level set of barriers to PA 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.