Parental management of asthma triggers within a child's environment

Background: Control of environmental precipitants of asthma is an important component of self-management. Objective: To assess the type and frequency of attempts by families to control environmental precipitants of symptoms and their degree of consistency with current guidelines. Methods: We analyzed data from a nationwide sample of 896 children (2-12 years) with asthma. We collected data on insurance, race, sex, income, asthma education exposure, and severity. Parents were asked open-ended questions about their child's asthma triggers and what, if any, actions they took to control these triggers. Results: We completed interviews with the parents of 896 of 1077 (83%) eligible patients. Patients had a mean age of 7.2 years, 65% were boys, 13% had Medicaid insurance, 12% were African American, and 31% had persistent asthma. Eighty percent (717/896) of parents could identify at least 1 asthma trigger (mean, 2.2; range, 0-9). Eighty-two percent (582/717) of these parents had attempted an environmental control measure. Of 1788 actions initiated, 916 (51%) were unlikely to be beneficial on the basis of current guidelines. No specific demographic characteristic predicted which parents were more or less likely to institute environmental controls. Conclusion: In our sample, more than half (51%) of the environmental actions initiated were not specifically endorsed by current guidelines. Improving awareness about recognized methods to address triggers may help families use more effective measures. Clinicians should not assume that they can predict which families will be more or less likely to attempt environmental control, but should provide education regarding effective environmental measures for all families with potentially modifiable asthma triggers.