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A1081 - Cultural and Contextual Mechanisms Relevant to Asthma and Physical Activity in Urban Children
Author Block: D. Koinis-Mitchell; Child and Family Psychiatry, Brown Med School, Providence, RI, United States.
Rationale: Asthma and obesity are disproportionately observed in urban children. National guidelines recommend 60 minutes of physical activity daily for children and asthma clinical guidelines recommend physical activity provided asthma is well controlled. Using objective assessments of asthma and physical activity during a two-week period in a sample of urban children with persistent asthma, we assessed cultural (e.g., caregivers’ perceptions of exercise as a dangerous trigger for asthma; children’s fear of asthma,) and contextual (e.g., neighborhood unsafety) processes relevant to asthma and the neighborhood setting that may be associated with physical activity in urban children.
Methods: Data are from a longitudinal study assessing asthma and physical activity in urban children with persistent asthma (ages 7-9, n=150). Lung function (FEV1 % predicted) was assessed by an electronic, hand-held spirometer, asthma control by the Asthma Control Test, and physical activity by the Actigraph wGT3X BT. Assessments of exercise as an asthma trigger and fear of asthma were completed by caregivers and children, respectively.
Results: On average, children engaged in 45 minutes a day of moderate to vigorous physical activity (MVPA). Participants met MVPA guidelines (at least 60 min/day) on 30% of days. Results from generalized linear models showed that caregivers’ perception of exercise was associated with less MVPA in children (b=-4.19, SE=1.60, p=.01), and a lower probability of meeting MVPA guidelines (OR=.57, 95% CI: .36-.96). Among children with well controlled asthma, caregiver perceptions of exercise were associated with less participation in MVPA in children (b=-5.00, SE=2.15, p=.02). These results were not observed among children with poorly controlled asthma.
When models controlled for children’s asthma symptoms and neighborhood risk characteristics, caregivers’ perceptions of exercise (b=-5.19, SE=1.68, p=.003) and perceived neighborhood safety (b=-4.18, SE=2.40, p=.05) remained significant predictors of MVPA. In analyses stratified by ethnicity, these associations were found to be significant among Latinos only.
When examining children’s fear of asthma and MVPA, among those with poorly controlled asthma, children’s fear was associated with less MVPA (b=-5.33, SE=2.54, p=.05). There was no association among those with well controlled asthma. Analyses are underway to examine the moderating role of cultural and contextual processes on the association between asthma status and physical activity.
Conclusions: Along with poor asthma control, caregivers’ perceptions of exercise, children’s perception of fear, and neighborhood safety are predictive of physical activity participation in urban children. Improving control, participation in physical activity, and modifying perceptions of asthma and exercise are important intervention targets.