Persistent differences in asthma self-efficacy by race, ethnicity, and income in adults with asthma
Year: 2014
Type: article
Abstract: Ifna H. Ejebe ABa*, Elizabeth A. Jacobs MD, MAPPab & Lauren E. Wisk PhDca Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA, b Health Innovation Program, Division of General Medicine, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA, and c Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USACorrespondence: Ifna H. Ejebe, Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, 610 North Walnut Street, Madison, WI 53726, USA. Tel: +1-617-6861653. Fax: +1-888-2632864. E-mail: [email protected]: The objective of this population-based study was to determine if and to what extent there are differences in asthma self-efficacy by race/ethnicity and income, and whether health status, levels of acculturation, and health care factors may explain these differences. Methods: We conducted a secondary data analysis of asthma self-efficacy using the 2009 and 2011–2012 California Health Interview Survey, in adults with asthma (n = 7874). In order to examine if and how the effect of race/ethnicity and income on asthma self-efficacy may have been altered by health status, acculturation, and health care factors, we used staged multivariable logistic regression models. We conducted mediation analyses to evaluate which of these factors might mediate disparities in self-efficacy by race/ethnicity and income. Results: 69.8% of adults reported having high asthma self-efficacy. Latinos (OR 0.66; 95% CI 0.51–0.86), African-Americans (OR 0.50; 95% CI 0.29–0.83), American Indian/Alaskan Natives (OR 0.55; 95% CI 0.31–0.98) and Asian/Pacific Islanders (OR 0.34; 95% CI 0.23–0.52) were less likely to report high self-efficacy compared to Whites. Individuals with income below the federal poverty level (OR 0.56; 95% CI 0.40–0.78) were less likely to report high self-efficacy compared to higher income individuals. The relationship between income and self-efficacy was no longer significant after further adjustment for health care factors; however, the differences in race and ethnicity persisted. Receiving an asthma management plan mediated the relationship in certain subgroups. Conclusions: Addressing modifiable health care factors may play an important role in reducing disparities in asthma self-efficacy.
Source: Journal of Asthma
Language: English
Subfield: Physiology
Field: Medicine
Domain: Health Sciences
Open Access status: green
Awards: G1753791066, G295662594, Training in Child Health Services Research and Implementation Science, Institutional Clinical and Translational Science Award, Institutional Clinical and Translational Science Award, Integrated Training For Physician-Scientists, CHILD HEALTH SERVICES RESEARCH TRAINING PROGRAM
OpenAlex ID: W1997710868