Background: There are well documented associations between unmet social needs and undesirable health outcomes, but little data exist on the association between unmet social needs and stress in families of children with asthma. Objective: To document the relationship between unmet social needs and parental stress in a Canadian pediatric asthma clinic. Design/Methods: Ongoing prospective observational study to determine the association between unmet social needs and parental stress was conducted in a tertiary care pediatric asthma clinic, between September 2022 and September 2023. Participants were parents of children with a diagnosis of asthma, treated with at least one controller medication. Unmet social needs were collected by parental self-report using a questionnaire assessing 8 domains: employment, housing, ability to pay for utilities, financial resources, food security, transportation, childcare, and education. The four-item Perceived Stress Scale was used to assess how parents perceived stress and how they felt they were able to manage situations in their lives. Chi-square tests compared our independent variable, the presence vs. absence of unmet social needs, to our dependent variables; each measure of stress (control over important aspects of ones’ life, confidence in ability to overcome problems, feeling that everything was going well, ability to overcome too many accumulated difficulties). Results: Of 162 participants, seventy-seven (48%) reported at least one unmet social need. Compared to participants without unmet social needs, those with unmet needs were more likely to report having no control over important aspect of their work or main activity (p < 0.001); less likely to report having confidence in their ability to overcome problems (p < 0.001); less likely to report having the feeling that everything was going well (p < 0.001); and less likely to report having the ability to overcome too many accumulated difficulties (p < 0.001).
Conclusion(s): Findings suggest significant association between unmet social needs and parental stress of children with asthma. Parental stress and unmet social needs may concomitantly increase the burden of adhering to asthma controller medication, making treatment adherence more challenging through pathways related to the interactions between cognitive burden and precarious living situations. This ongoing Canadian study of children on asthma controller medication seen in a pediatric asthma clinic seeks to elucidate the mechanisms by which these factors make adherence to asthma medication more challenging for families, so that these challenges can be addressed.
