Parent Nativity and Child Asthma Control in Families of Mexican Heritage: The Effects of Parent Depression and Social Support.

Abstract Objective Research has repeatedly demonstrated that parent foreign nativity has a protective effect on child asthma outcomes among Mexican Americans, but the mechanisms underlying this relationship are not well understood. The current study explored parent depression as a mediator and social support as a moderator of the parent nativity-child asthma control pathway. Methods Data come from the baseline sample of a trial (NCT02481986) testing community interventions for 223 children aged 5-16 with uncontrolled asthma. We focused on parent/child dyads of Mexican heritage (N=165; mean age=9.08, SD=2.94; 57.3% with Mexico-born parent). Asthma control was defined using the child and adult versions of the Asthma Control Test (ACT). Psychosocial factors included parent depression symptoms and social (instrumental, informational, and emotional) support. Results Mexican-born parents had fewer depressive symptoms ( β ^ =-2.03, S E ^ =0.24) and children with better asthma control ( β ^ =1.78, S E ^ =0.24) than U.S.-born parents, p β ^ =-0.10, S E ^ =0.05, p=.07), with protective effects only observed at higher support levels. Last, among Mexico-born parents, the protective nativity effects on ACT declined with increasing residential years in the U.S. through 12 years. Conclusions This study is novel in identifying parent depression as one mechanism underlying the effects of parent nativity on child asthma control, but results suggest that the health advantages may depend on availability of support. Providing resources for parent depression and instrumental support (transportation, childcare) can optimize asthma interventions in this population.