Poster #48 - Youth Depressive Symptoms Moderate Associations between Family Functioning, Neighborhood Stress, and Lung Function

• In Event: Poster Session 02

Abstract

Introduction: Poor family functioning and neighborhood stress have both been correlated with adverse child asthma outcomes (e.g., low lung function, poor asthma control; Tobin et al., 2016; Weinstein et al., 2019). These factors not only impact asthma and physical health outcomes, but can also worsen youth psychological outcomes (e.g., depressive symptoms). Mental health has also been found to exacerbate asthma symptoms among youth (Weinstein et al., 2019). Given that family functioning and neighborhood stress have been linked to asthma and mental health outcomes, this study examined associations between family and neighborhood factors, youth mental health, and asthma outcomes. Specifically, we investigated youth depressive symptoms as a moderator between neighborhood stress and family functioning on youth asthma outcomes (e.g., asthma control, quality of life [QOL], lung function).

Methods: Participants included 121 youth (57.9% male; 91.7% African American/Black) and their primary caregivers (85.1% mothers) from an urban area. Youth ranged in age from 7.02 to 17.79 years old (M = 12.61, SD=2.93) and reported on their depressive symptoms, neighborhood stress, asthma control, and QOL. Caregivers reported on family functioning and their own depressive symptoms. Lung function was derived from forced expiratory volume in one second (FEV1) and was measured via handheld spirometers. Youth were instructed to complete three maneuvers twice daily (morning and evening) for two weeks. The highest value was retained at each time point and average FEV1 values taken across the assessment period were used in analyses.

Results: Two moderation models were conducted that examined outcomes simultaneously (asthma control, QOL, FEV1) with each predictor (neighborhood stress, family functioning). Covariates included youth age, sex, poverty status, and caregiver depressive symptoms. In the first model, neighborhood stress was associated with asthma control (est=-.17, p=.001), QOL (est=-.04, p=.001), and FEV1 (est=-.02, p=.04). Youth depressive symptoms moderated the association between neighborhood stress and youth FEV1 (est=-.01, p=.04). Simple slope analyses found that for youth with higher levels of depressive symptoms (b=-.03, p=.001), greater neighborhood stress was associated with lower FEV1 values. In the second model, family functioning (est=-.32, p=.05) was associated with FEV1, but not asthma control or QOL. Youth depressive symptoms also moderated the association between family functioning and FEV1 (est =.49, p=.002). Poor family functioning was associated with lower FEV1 values for youth with high levels of depressive symptoms (b=-.80, p=.002) in simple slope analyses.

Discussion: Findings suggest that in a sample of predominately African American/Black youth with asthma, depressive symptoms moderated associations between neighborhood stress and lung function, and between family functioning and lung function. More neighborhood stress and worse family functioning were related to worse lung function for youth experiencing high depressive symptoms. However, youth depressive symptoms did not moderate associations of neighborhood stress and family functioning with asthma control or QOL. The results suggest that screening for depression in youth with asthma should be prioritized, especially for African American/Black youth. Therefore, it is important to not only target neighborhood and family level factors in intervention work, but also youth mental health to promote better asthma outcomes.

Authors

• Stephanie Madden, University of Massachusetts Lowell
  Presenting Author

• Samantha Miadich, University of Massachusetts Lowell

• Robin Everhart, Virginia Commonwealth University