Asthma Self-Management Goals, Beliefs and Behaviors of Urban African American Adolescents Prior to Transitioning to Adult Health Care

• Urban African American adolescents with asthma have not been studied in the health care transition literature.
• We studied the self-management goals of urban African American adolescents with asthma prior to making a health care transition.
• An understanding of self-management goals is essential to facilitate health care transition preparation.
• Adolescents' level of development in identity formation, autonomy and interdependence on parents influence their goals.
• Urban African American adolescents' goals for asthma self-management are in part informed by misinformation on their disease process and medication side effects.

Adolescence is a unique time of development incorporating a transition from child centered to adult centered health care. This transition period can be particularly challenging for individuals with a chronic disease such as asthma. Inadequate transition planning during adolescence may place an already vulnerable population such as African American adolescents with known health disparities in asthma prevalence, morbidity and mortality at risk for a continuation of poor health outcomes across the lifespan. Central to transition planning for these youth is the core element of developing and prioritizing goals. The purpose of this qualitative study was to explore the asthma self-management goals, beliefs and behaviors of urban African American adolescents prior to transitioning from pediatric to adult health care.MethodsA focus group composed of 13 African American adolescents with asthma ages 14–18 years from an urban population was conducted. Responses from transcripts and field notes were reviewed using an iterative process to best characterize asthma self-management goals and beliefs that emerged.ResultsFour core themes were identified: 1) medication self-management, 2) social support, 3) independence vs. interdependence, and 4) self-advocacy. Medication self-management included subthemes of rescue medications, controller medications and medication avoidance. The social support theme included three subthemes: peer support, caregiver support and healthcare provider support.ConclusionFindings suggest that adolescents with asthma form both short term and long term goals. Their goals indicated a need for guided support to facilitate a successful health care transition.