Self-efficacy as a Mediator of the Relationships Between Obesity and Asthma Outcomes in Black and Latino Children.

Abstract

Background: Asthma and obesity are two of the most common pediatric conditions in the USA that are comorbid and exacerbate one another. This study examined whether asthma management self-efficacy-perceived ability to control asthma-mediates the relationship between obesity and asthma outcomes, including pulmonary function, perception of respiratory compromise, and emergency department visits.

Methods: In total, 303 children ages 10-17 were recruited from clinics in the Bronx. Participants were on average 13.20 years old (SD = 2.22), 53.8% male, 62.7% Latino, and 47.2% Black. The study consisted of a baseline visit with spirometry testing to assess pulmonary function and questionnaires to evaluate demographics, healthcare utilization, and self-efficacy. Participants were also assigned peak flow monitors to measure perception of respiratory compromise, which were utilized at home twice daily for 4 weeks.

Results: Obesity was associated with worse pulmonary function (β =  - 3.83, p = 0.03). Asthma management self-efficacy was associated with more accurate perception (β = 5.14, p = 0.03). Obesity was not associated with self-efficacy, accurate perception, or emergency department visits. Asthma management self-efficacy did not mediate the relationship between obesity and asthma outcomes, nor was it associated with pulmonary function or emergency visits.

Conclusions: This study confirms the association between obesity and worse pulmonary function in Black and Latino children. The link between higher asthma management self-efficacy and more accurate perception of respiratory compromise independent of obesity status suggests a modifiable target for intervention irrespective of body habitus.