# Child Asthma Exacerbation: Role of Caregiver Risk Beliefs

> **NIH NIH R01** · WASHINGTON UNIVERSITY · 2021 · $575,496

## Abstract

ABSTRACT/PROJECT SUMMARY
Asthma affects over 6.2 million children in the U.S., particularly children who are African American and children
whose parents have limited incomes and formal education. Yet, interventions that attempt to reduce asthma
exacerbation by educating caregivers of asthmatic children are time and resource intensive and largely have
enjoyed only modest success. We propose pausing intervention implementation and dissemination efforts to
gain a thorough understanding of the basic scientific nature of caregivers' proxy risk beliefs and how the beliefs
interact with the social context to shape caregivers' risk-reducing actions. By doing so, we can address three
barriers to creating effective childhood asthma exacerbation interventions: (1) limited understanding of how
caregivers think about asthma and the heuristics (judgment shortcuts) and biases that color caregiver beliefs,
(2) limited evidence about how caregiver risk beliefs interact with the social context to influence decision
making, and (3) limited evidence about how caregiver risk beliefs translate into their risk reduction behaviors
and their child's health. We propose filling these gaps in scientific knowledge by employing a mixed methods
approach. We will conduct qualitative interviews of caregivers of children with asthma who reside in one of two
underserved communities (N=40) and a quantitative survey of caregivers recruited from a panel comprised of a
probability-based random sample of adults in the US (N=801). The unique features of this project are that it (a)
combines multiple methods to understand caregiver beliefs, (b) examines beliefs at three stages of the asthma
exacerbation continuum (triggers, symptoms, and symptom management), (c) explores how beliefs interact
with the social context to influence decisions about engaging in behaviors that reduce exacerbation risk, (d)
uses psychometric analytic methods to understand the cognitive structures underlying caregivers' risk beliefs,
and (e) capitalizes on an interdisciplinary research team with experts in health, social, and cognitive
psychology, anthropology, health behavior intervention development and implementation, pediatric
pulmonology, and statistics. This project is significant because elucidating the structures, heuristics, biases,
and social and contextual factors that drive caregivers' decisions for their child will illuminate strategies for
directly intervening on the most proximal determinants of behavior. This targeted approach will inform the
development of a highly effective caregiver-based intervention that is time- and resource-efficient while
accommodating the social and contextual features that may constrain or facilitate caregivers' risk-reducing
behavior. We will also make a significant scientific advance by extending basic risk perception research
through considering both the caregiver-child relationship and the broader social context.

## Key facts

- **NIH application ID:** 10227109
- **Project number:** 5R01HL137680-04
- **Recipient organization:** WASHINGTON UNIVERSITY
- **Principal Investigator:** JAMES A SHEPPERD
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $575,496
- **Award type:** 5
- **Project period:** 2018-09-01 → 2023-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10227109

## Citation

> US National Institutes of Health, RePORTER application 10227109, Child Asthma Exacerbation: Role of Caregiver Risk Beliefs (5R01HL137680-04). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10227109. Licensed CC0.

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