Health-Related Decision-Making in Early Adolescents With Poorly Controlled Asthma

Objective: Caregiver–adolescent collaborative decision-making is a key component of effective self-management, although there is limited understanding of this relationship in pediatric asthma. The current study examined the association between parent and youth decision-making and asthma self-management behaviors. Method: Participants included 33 youth ages 12–15 years (M _age = 13.18, SD = 1.16) with poorly controlled, persistent asthma and their caregivers. Participants completed the Family Asthma Management System Scale interview to assess core aspects of asthma management. The Decision Making Involvement Scale was administered to evaluate caregiver and adolescent behaviors during asthma-related decision-making. Results: Seventy percent of dyads reported discussing the adolescent’s asthma in the past 2 weeks. Forty-seven percent of families reached a final decision during the discussion, and 18% made a partial decision. Either the caregiver (41%) or the dyad together (27%) made the final decision. Youth whose parents made the final decision reported poorer responses to acute asthma symptoms (p = .03, d = 0.99). Higher parental expression of information was associated with better family response to acute asthma symptoms, p = .045, R ² = 0.69. Conclusions: Findings indicate that joint caregiver–youth collaborative decision-making and parent involvement in asthma-care decision-making were associated with better response to asthma exacerbations. A significant portion of families is not discussing their adolescent’s asthma, and future research is needed to identify what families are at risk for reduced communication regarding asthma-care decision-making. Health professionals should assess both caregiver and adolescent decision-making involvement when addressing asthma self-management.