Parent Nativity and Child Asthma Control in Families of Mexican Heritage: The Effects of Parent Depression and Social Support.,Academic Pediatrics

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Parent Nativity and Child Asthma Control in Families of Mexican Heritage: The Effects of Parent Depression and Social Support.
Academic Pediatrics ( IF 3.0 ) Pub Date : 2020-05-12 , DOI: 10.1016/j.acap.2020.05.007
Sally M Weinstein ₁ , Kimberly Orozco ₁ , Oksana Pugach ₁ , Genesis Rosales ₁ , Nattanit Songthangtham ₁ , Molly A Martin ₁

Affiliation

Objective

Research has repeatedly demonstrated that parent foreign nativity has a protective effect on child asthma outcomes among Mexican Americans, but the mechanisms underlying this relationship are not well understood. The current study explored parent depression as a mediator and social support as a moderator of the parent nativity-child asthma control pathway.

Methods

Data come from the baseline sample of a trial (NCT02481986) testing community interventions for 223 children aged 5 to 16 with uncontrolled asthma. We focused on parent/child dyads of Mexican heritage (N = 165; mean age = 9.08, standard deviation = 2.94; 57.3% with Mexico-born parent). Asthma control was defined using the child and adult versions of the Asthma Control Test (ACT). Psychosocial factors included parent depression symptoms and social (instrumental, informational, and emotional) support.

Results

Mexican-born parents had fewer depressive symptoms ( $\hat{β}$ = −2.03, $\hat{SE}$ = 0.24) and children with better asthma control ( $\hat{β}$ = 1.78, $\hat{SE}$ = 0.24) than US-born parents, P < .0001. Analyses suggested partial mediation of the nativity-ACT path via parent depression (P < .001). An interaction between Instrumental Support and Nativity was marginally significant ( $\hat{β}$ = −0.10, $\hat{SE}$ = 0.05, P = .07), with protective effects only observed at higher support levels. Last, among Mexico-born parents, the protective nativity effects on ACT declined with increasing residential years in the United States through 12 years.

Conclusions

This study is novel in identifying parent depression as one mechanism underlying the effects of parent nativity on child asthma control, but results suggest that the health advantages may depend on availability of support. Providing resources for parent depression and instrumental support (transportation, childcare) can optimize asthma interventions in this population.

中文翻译：

墨西哥传统家庭的父母出生和儿童哮喘控制：父母抑郁和社会支持的影响。

客观的

研究一再表明，父母的外来出生对墨西哥裔美国人的儿童哮喘结果有保护作用，但这种关系的潜在机制尚不清楚。目前的研究探索了父母抑郁作为父母出生 - 孩子哮喘控制途径的中介和社会支持作为调解人。

方法

数据来自一项试验 (NCT02481986) 的基线样本，该试验测试了 223 名 5 至 16 岁哮喘未控制儿童的社区干预措施。我们专注于墨西哥传统的父母/子女二人组（N = 165；平均年龄 = 9.08，标准差 = 2.94；墨西哥出生的父母为 57.3%）。使用哮喘控制测试 (ACT) 的儿童和成人版本定义哮喘控制。社会心理因素包括父母的抑郁症状和社会（工具、信息和情感）支持。

结果

墨西哥出生的父母的抑郁症状较少（ $\hat{β}$ = -2.03， $\hat{东南}$ = 0.24) 和哮喘控制较好的儿童 ( $\hat{β}$ = 1.78, $\hat{东南}$ = 0.24) 比美国出生的父母，P < .0001。分析表明，通过父母抑郁症对诞生-ACT 路径的部分中介作用（P < .001）。工具性支持和耶稣诞生之间的相互作用是微不足道的（ $\hat{β}$ = -0.10， $\hat{东南}$ = 0.05, P = .07)，保护作用仅在较高的支持水平下观察到。最后，在墨西哥出生的父母中，随着在美国居住年数增加到 12 年，对 ACT 的保护性出生效应下降。