Family Approach to Asthma Management (FAAM)
Pediatric asthma is the most common childhood chronic illness, affecting over 5 million children in the United States. It is the number one cause for school absences and can result in death if not properly treated. While not curable, asthma symptoms can be reduced if children regularly take their medicine, avoid environmental allergens (i.e., tobacco smoke, pet dander), and stay calm under stressful conditions. However, less than fifty percent of children regularly take their medicine all the time, upwards of half of children with asthma are exposed to tobacco smoke on a regular basis, and children with asthma are at increased risk for developing anxiety disorders.
The Family Approach to Asthma Management (FAAM) study is examining two different interventions aimed at improving asthma symptoms and reducing family stress. This is a primary care based randomized control trial for families who have a child with asthma between the ages of 8 and 12.
One of the interventions is based on findings from the Family Life and Asthma Project (FLAP) conducted by Barbara Fiese and colleagues at Syracuse University. This five- year study of 215 families with children between the ages of 5 and 12 who have persistent asthma focused on medical adherence and daily family life. Investigators assessed the child’s lung functioning, daily patterns of sleep, and parental stress. Researchers also observed family mealtimes, interviewed parents regarding their experiences in managing asthma, and gathered teacher reports of the child’s behavior in the classroom.
Findings from this study include:
Parents who create regular routines to remind their child to take his/her medicine report less stress in their life and their children worry less about their asthma symptoms;
Daily stressors in the household (kids not listening to parents, disrupted mealtime routines, late bedtimes) predict the likelihood that children will wake up in the middle of the night to the same degree as exposure to environmental allergens (e.g., dust mites, tobacco smoke)- thus family climate variables may be as potent as biological triggers to children’s sleep patterns;
Children with asthma who are overweight and/or meet the criteria for obesity experience a different type of mealtime interaction compared to their peers who are of average weight;
Parents of children with asthma experience a poorer quality of life (worry more, have more health symptoms themselves, feel emotionally drained) when there is a greater pile up of stressors (single parent household, more severe child asthma, family life stress);
The relationship between poor lung functioning and children’s separation anxiety is best explained by how effectively families manage communication during mealtimes.
- Barbara H. Fiese, PhD, The Pampered Chef, Ltd. Endowed Chair in Family Resiliency, Professor and Director of the Family Resiliency Center
- Donald Davison, MD, Pediatric Pulmonology, The Carle Foundation
- Barbara Anderson, MS, MSW, Project Coordinator
- Janice Douglas, RT, The Carle Foundation
- Meghan Fisher, MA, Project Coordinator
Fiese, B.H., Wamboldt, F.S., Anbar, R.D. (2005). Family asthma management routines: Connections to medical adherence and quality of life. The Journal of Pediatrics, 146, 171-176.
Fiese, B. H., & Everhart, R. S. (2006). Medical adherence and childhood chronic illness: Family daily management skills and emotional climate as emerging contributors. Current Opinions in Pediatrics, 18, 551-557.
Fiese, B. H., Winter, M. A., Sliwinski, M., & Anbar, R. (2007). Nighttime waking in children with asthma: An exploratory study of daily fluctuations in family climate. Journal of Family Psychology, 21, 95-103.
Jacobs, M. P., & Fiese, B. H. (2007). Family mealtime interactions and overweight children with asthma: Potential for compounded risks? Journal of Pediatric Psychology, 32, 64-68.
Fiese, B. H., Winter, M. A., Anbar, R. D., Howell, K. J., & Poltrock, S. (2008). Family climate of routine asthma care: Associating perceived burden and mother-child interaction patterns. Family Process, 47, 63-79.
Everhart, R. S., Fiese, B. H., Smyth, J. M. (2008). A cumulative risk model predicting caregiver quality of life in pediatric asthma. Journal of Pediatric Psychology, 33, 809-818.
- The National Institute of Mental Health; National Institute of Child Health and Human Development
Meghan Fisher, Project Coordinator
2017 Doris Kelley Christopher Hall, MC-081
904 West Nevada St.
Urbana, IL 61801
Primary care based interventions that are tailored to the routines of daily family life have the potential to increase medical adherence, reduce caregiver burden, and improve asthma symptoms.