Poor Hispanic families who have children with asthma are being taught how to cope with the illness and other challenges through a federally funded $1.8 million study being conducted by a professor at Texas A&M University.
Walking the primarily Spanish-speaking families through problem-solving exercises can help them get a grasp of their problems and move toward resolving them, says principal investigator James Varni, who has worked with children's hospitals for more than 30 years as a pediatric psychologist specializing in pediatric chronic health conditions. In addition to teaching research methods in urban planning at Texas A&M's College of Architecture, Dr. Varni also serves as a professor and vice chair for research in the pediatrics department of The Texas A&M University System Health Science Center - College of Medicine.
The study, "Reducing Barriers to Care for Vulnerable Children with Asthma," is funded by the Maternal and Child Health Bureau, Health Resources and Services Administration, U.S. Department of Health and Human Services.
The research involves several hundred families who visit several community service sites in San Diego. Trained community coordinators, native speakers called promotoras, work with the families during home visits.
"This was a very practical way to work with the families, since the promotoras were already serving as their care coordinators," Varni explains. "We built our problem-solving intervention onto this ongoing state-funded program. It helped that the promotoras were already working with these families, so they were more comfortable with the intervention."
The five-step process, widely used in the world of research, was adapted to help empower families, Varni says. The families start with problem orientation, or accepting that challenges with managing their child's asthma - along with the importance of maintaining a positive attitude - are a normal part of their everyday lives.
Next, they define the specific problems associated with asthma management, then they brainstorm for potential solutions to try out. Once a solution is implemented, if they are not happy with the outcome, an alternative solution is sought from the list they previously generated.
"Through the intervention, these families can begin this process of advocating for themselves and finding some of their own solutions, using problem-solving techniques," Varni says. "With this process, the care coordinators work with the families to facilitate brainstorming new solutions to their identified asthma management problems, and guide them in looking at all their options.
"Too many times people censor their brainstorming. They stifle themselves, so they run out of solutions."
Varni says once the families learn the steps, they can use them to address other childhood challenges besides asthma - even those outside the realm of healthcare.
"If their child is being bullied at school, this process helps the family walk through the problem-solving process to help resolve that situation, as well," Varni says.
The project is winding down in this, its fourth year. Varni says he is completing his research and beginning to write his results for publication.
Varni also is a fellow of the American Psychological Association, the Society of Behavioral Medicine, and the Society of Pediatric Psychology, and has published more than 200 journal articles and book chapters in behavioral medicine, and four books on children and families. He is a recipient of the "Significant Research Contributions Award" from the American Psychological Association.
