Sue K. Adams

Complementary and Alternative Medication (CAM) Use and Asthma Outcomes in Children: An Urban Perspective

Asthma is a disease of significant social magnitude that disproportionately affects children from minority and low-income backgrounds. Poor asthma management is one of the leading causes for high morbidity and mortality rates. In addition to conventional medications, many parents use complementary and alternative medication (CAM) to treat their childs asthma symptoms. This study explored the impact of CAM use on asthma control and risks for nonadherence to conventional medications in 66 parents of children with asthma. Positive parental beliefs about CAM were significantly associated with greater risks for nonadherence and poorer asthma control. Future research should assess the specific pathways that may account for these associations among CAM use and asthma outcomes.

Sleep Quality as a Mediator Between Technology-Related Sleep Quality, Depression, and Anxiety

This study examines (a) relations among technology use during sleep time, sleep quality, and depression/anxiety and (b) time awake due to technology use. Two hundred thirty-six college students completed self-report questionnaires and week-long sleep diaries. Results revealed that 47 percent of students reported night-time waking to answer text messages and 40 percent to answer phone calls. Regression analyses indicated that higher levels of technology use after the onset of sleep predicted poorer sleep quality, and poorer sleep quality predicted symptoms of depression/anxiety. Finally, sleep quality is a mediator between technology use after the onset of sleep and depression/anxiety. College students who have difficulty setting boundaries around technology use may be at increased risk for psychological health concerns.

Two approaches to tailoring treatment for cultural minority adolescents

At this time, compared with mainstream (Caucasian) youth, cultural minority adolescents experience more severe substance-related consequences and are less likely to receive treatment. Although several empirically supported interventions (ESIs), such as motivational interviewing (MI), have been evaluated with mainstream adolescents, fewer published studies have investigated the fit and efficacy of these interventions with cultural minority adolescents. In addition, many empirical evaluations of ESIs have not explicitly attended to issues of culture, race, and socioeconomic background in their analyses. As a result, there is some question about the external validity of ESIs, particularly in disadvantaged cultural minority populations. This review seeks to take a step toward filling this gap, by addressing how to improve the fit and efficacy of ESIs like MI with cultural minority youth. Specifically, this review presents the existing literature on MI with cultural minority groups (adult and adolescent), proposes two approaches for evaluating and adapting this (or other) behavioral interventions, and elucidates the rationale, strengths, and potential liabilities of each tailoring approach.

Complementary and Alternative Medicine Use and Adherence to Asthma Medications Among Latino and Non-Latino White Families

OBJECTIVE The current study sought to evaluate patterns of complementary and alternative medicine (CAM) use in a sample of Latino and non-Latino white (NLW) children with asthma to determine whether parental beliefs about conventional medications and barriers to obtaining these medications were related to CAM use and to assess whether CAM use was associated with decreased adherence to controller medications. METHODS Participants included 574 families of children with asthma from NLW, Puerto Rican (PR), and Dominican backgrounds from Rhode Island (RI) and from Island PR. All parents completed a brief checklist of barriers to medication use and an assessment of CAM approaches. A subsample of 259 families had controller medication use monitored objectively for approximately 1 month by MDILog (fluticasone propionate), TrackCap (montelukast), or dosage counter (fluticasone/salmeterol combination). RESULTS Prevalence of CAM use was high among Latino families. Perceived barriers to obtaining medication were related to increased CAM use in PR families from RI. Elevated medication concerns were positively associated with CAM use among NLW and Island PR families. CAM use was positively related to objective adherence within NLW families, and unrelated in other groups. CONCLUSIONS CAM use is common among Latino families with asthma. Among some families, CAM use may be initiated as a way to cope with barriers to obtaining medication or when parents have concerns about conventional medications. Families who report CAM use do not appear to be substituting CAM for conventional asthma medication.

Adolescent Sleep and Cellular Phone Use: Recent Trends and Implications for Research

Adolescent sleep needs range from 8.5–10 hours per night, with older adolescents requiring less sleep than younger adolescents. On average, however, American adolescents receive between 7.5–8.5 hours of sleep per night, with many sleeping fewer than 6.5 hours on school nights. Cellular phone use is emerging as an important factor that interferes with both sleep quality and quantity, particularly as smartphones become more widely available to teens. This review paper has three objectives. First, we will describe adolescent sleep patterns and the effects of sleep deprivation on adolescent physical and mental health. Second, we will describe current trends in technology use among adolescents, making associations to how technology impacts sleep. Lastly, we will discuss some of the methodological barriers of conducting sleep and technology research with adolescents and young adults and offer suggestions for overcoming those barriers. We will also discuss implications for healthcare providers.

The Puzzle of Problem-Solving Efficacy: Understanding Anxiety Among Urban Children Coping with Asthma-Related and Life Stress

Abstract Children with asthma living in urban environments are at risk for experiencing anxiety by virtue of both social context and health-related stressors. Although the use of active coping strategies is generally associated with more optimal psychosocial functioning, there is evidence that active coping is less helpful in response to uncontrollable or severe stress. Expectations that one can fix a problem that is uncontrollable or insurmountable may create distress. Problem-solving efficacy was examined as a moderator of the association between stress and anxiety among children residing in inner-city neighborhoods. It was hypothesized that childrens perceptions of high problem-solving efficacy would exacerbate their vulnerability to stress. Forty-five parent–child dyads were recruited from urban community health centers. Most participants were members of ethnic minority groups. Hierarchical multiple regression analyses revealed main effects of asthma-related stress and life stress on childrens anxiety. However, these effects were moderated by problem-solving efficacy. Asthma-related stress and life stress were positively associated with anxiety only for children who had the highest levels of problem-solving efficacy. In other words, positive expectations about the ability to solve problems functioned as a liability for highly stressed children. Implications for psychosocial interventions with at-risk children are discussed.

Family—school connections and internalizing problems among children living with asthma in urban, low-income neighborhoods

Children with asthma living in urban environments are at risk for experiencing internalizing problems and difficulties at school due to social context and health-related stressors. Parent confidence and participation in the school and children’s attitudes about school were explored in association with children’s depressed mood and school anxiety. Forty-five parent—child dyads were recruited from urban community health centers. Most participants were members of ethnic minority groups. Hierarchical multiple regression analyses revealed that higher levels of parent confidence in the school were associated with fewer symptoms of school anxiety in children. Children’s attitudes toward school moderated the relation between parent participation in the school and children’s depressed mood. Specifically, lower levels of parent participation were associated with higher levels of depressed mood only for children with the least positive school attitudes. Although preliminary, these results suggest the importance of attending to family—school connections to optimize the school-related psychological functioning of children living with asthma in urban environments.

A Pilot Examination of Self-Esteem, Depression, and Sleep in College Women.

While sleep deficits in adulthood are common and worsening, college women experience significantly more sleep problems and depression than their male counterparts. In recent years, sleep has been investigated as one of the primary contributors to college functioning and GPA. No known study, however, has investigated the connection between self-esteem, depression and sleep. Questionnaire assessments were given to 43 female college juniors and seniors, including: demographic information, Rosenberg Self-esteem Scale, Beck Depression Inventory, and Pittsburg Quality Sleep Index. This pilot study investigates the relationship between college self-esteem and sleep quality, as mediated by depression. The results of the study indicate that self-esteem predicts both depression and sleep quality, such that decreased levels of self-esteem are associated with higher levels of depression and decreased sleep quality. Moreover, depression also predicts sleep quality and serves to mediate the relation between self-esteem and sleep quality. The results suggest that students’ self-esteem plays a significant role in the experience of depression, and that depression is the primary mechanism through which self-esteem influences sleep.

Perspectives on complementary and alternative therapies in asthma

Asthma is a chronic disease that affects millions of individuals living in the USA. Proper asthma management is essential for controlling asthma symptoms and exacerbations. In recent years, however, there has been increased recognition of individuals using complementary and alternative medicine (CAM) to treat asthma. This article reviews the status of the current literature on various cultural factors that influence CAM use. In addition, current research of two widely used forms of CAM, herbal remedies and relaxation techniques, is presented. Future directions and recommendations to increase the methodological rigor of CAM research are discussed, particularly as they pertain to herbal remedies and relaxation strategies. The importance of well-designed research studies, including observational studies and randomized controlled trials, is highlighted.

Nighttime Notifications and Compulsivity Illuminate the Link Between Emerging Adults’ Cellphone Use and Sleep-Related Problems.

Although higher levels of cellphone use have been correlated with sleep problems, few studies have investigated specific qualities of cellphone use that may account for this relationship. Recently, significant associations among nighttime cellphone use, compulsive orientation toward cellphone use, and multiple characteristics of compromised sleep were found in a sample of undergraduate students enrolled at a small liberal arts college (Murdock, Horissian, & Crichlow-Ball, 2016). The current study expands upon these findings. Data were collected from 2 samples of undergraduates: 273 students enrolled at a midsized state university and 152 self-identified students recruited through Mechanical Turk. Hierarchical regression analyses were conducted to test the hypotheses that nighttime cellphone notifications and qualities of compulsive cellphone use would predict sleep problems and daytime sleepiness, even after taking into account the overall frequency of cellphone use. Full support for hypotheses was found for both domains of sleep-related functioning in both samples. Findings suggest that contextual aspects of cellphone use, such as its timing and compulsivity, may be more important to emerging adults’ sleep than aspects of cellphone use such as the number of texts or time spent on calls. Sleep promotion programs for emerging adults should target specific cellphone use qualities—that is, the when, where, and how of cellphone use—to promote behavior change and improved sleep.