Interventions designed to enhance physical activity in urban children with asthma need to address both the management of asthma and physical activity, along with barriers and challenges to physical activity based on families’ neighborhood context, ethnic background, and weight status, according to the results of an analysis published in the Journal of Pediatric Psychology. Researchers obtained data in the current 2-week analysis within the context of a larger 5-year observational study that evaluated asthma and physical activity, as well as cultural and contextual factors, in a group of urban elementary school-aged children with persistent asthma over a 12-month period.
The researchers sought to assess objective measures of lung function in asthma and physical activity in diverse samples of children over a 2-week period. The initial goal of the study was to evaluate whether children’s levels of physical activity were consistent with recommended physical activity guidelines (>60 minutes per day) across the monitoring period, and whether differences existed based on racial/ethnic background and body weight. Study participants were recruited from both hospital-based ambulatory clinics and the 4 largest urban school districts in Providence, Rhode Island.
All eligible participants were between 7 and 9 years of age, attended public school in one of the 4 targeted school districts, had caregiver-reported physician-diagnosed asthma or had experienced breathing problems in the prior 12 months, and had a caregiver who self-identified as Latino (Puerto Rican or Dominican), Black or African American, or non-Latino White.
A total of 1345 individuals were screened for study eligibility, of whom 266 met study inclusion criteria. Overall, 147 families enrolled, with 142 of the children in these families having persistent asthma. All of the enrolling visits took place at the family’s home, where informed consent was obtained from the primary caregiver, as well as assent from the child, before completion of interview-based questionnaires. The second study visit took place at the hospital-based allergy and asthma clinic at least 2 weeks later, at which time a study clinician assessed and confirmed the child’s asthma diagnosis and severity, use of asthma medication(s), and height and weight.
Results of the study showed that the average daily moderate to vigorous physical activity (MVPA) of study participants was below the guideline-recommended levels. Significant differences in MVPA were reported based on racial/ethnic group (P =.04) and body weight (P =.001). Poorer asthma status was linked to lower MVPA in Latino and Black participants (P <.05 for both) and in children of normal body weight (P =.01). Body mass index (BMI) moderated the association between asthma and MVPA, with participants with lower BMIs having more optimal asthma status and higher MVPA levels. These associations decreased, however, among those participants with higher BMIs (P =.04).
A major limitation of the study was the fact that the study questions used warrant re-examination in larger samples of racially/ethnically diverse participants with asthma, as it remains unclear whether the differences observed in daily physical activity were actually clinically meaningful.
The investigators concluded that suboptimal asthma status is associated with less MVPA among urban children. Cultural/contextual factors and weight status appear to play a role in this relationship, thus justifying the need for future research and intervention.
Koinis-Mitchell D, Kopel SJ, Dunsiger S, et al. Asthma and physical activity in urban children. J Pediatr Psychol. Published online March 22, 2021. doi:10.1093/jpepsy/jsab023