Files
Abstract
This two-study dissertation investigated the roles of several psychosocial factors in health and functioning outcomes for youth with asthma through a biopsychosocial model, a framework pediatric psychologists have adopted to conceptualize how biological, psychological, and social factors influence asthma-related outcomes. The first study explored rates of family routines in families with young children with asthma, examined relationships between family routines and young children’s asthma severity and health statuses, and identified connections between family routines and flourishing in young children with asthma. Findings revealed that caregivers frequently engage in key family routines—reading, sharing meals, singing and telling stories, and maintaining consistent bedtimes— with significant differences observed in the frequency of singing and storytelling in those with mild asthma. Demographic factors such as poverty and neighborhood safety were predictive of asthma severity and overall health. Although singing and storytelling emerged as a unique predictor of health status and child flourishing, this study found no moderation effect of family routines on the relationship between health status and flourishing. This study underscores the need for further research into how specific family routines can enhance wellbeing among children with chronic conditions, highlighting the importance of environmental and community factors in shaping health outcomes. The second study examined the interplay between caregiver-perceived care coordination and school outcomes for children with asthma. Results revealed that better child health status and supportive neighborhoods are associated with improved experiences in care coordination, including reduced frustration and time spent coordinating care. Care coordination positively influenced school engagement and absenteeism; caregivers who reported receiving needed services and experiencing no frustration were less likely to report poor school outcomes. These results emphasize the importance of a biopsychosocial approach in care coordination programs, particularly for underserved populations, to mitigate the adverse effects of chronic conditions on educational attainment. Together, the two studies that comprise this dissertation highlight the importance of addressing psychosocial factors to support youth with chronic conditions.