Current Study
The current study compared the role of alternate caregivers
in a diverse sample of families of children with asthma. To
explore within group heterogeneity, groups were compared
based on the ethnic background and site, yielding four
different groups: NLW, PR, and DR families residing in
Rhode Island (RI), and PR families residing in PR. For
purposes of this study, we define alternate caregiver as
an adult living outside of the child’s home who spends
at least 6 hr per week caring for the child. We investigated
the relation of alternate caregivers to the child (e.g.,
grandmother, uncle), the average weekly length of time
they spent in a caregiving role, their knowledge and
involvement in asthma management, and the primary
caregiver’s confidence in the alternate caregiver’s asthma
management abilities. We also sought to determine
whether families with and without an identified alternative
caregiver differed on Family Asthma Management SystemScale (FAMSS; McQuaid et al., 2005) interview ratings of
medication adherence and balanced integration, and whether
family group served to moderate these associations.
Medication adherence and balanced integration FAMSS ratings
were chosen because of the likely impact alternate
caregivers may have on these domains. Other FAMSS
subscales (e.g., asthma knowledge) are unlikely to be
influenced by alternate caregivers.
We hypothesized that Island PR families would be
more likely to identify an alternate caregiver compared
with Latino families in RI and NLW families, as they are
likely to have more access to extended family in their
region of origin (Landale & Oropesa, 2001). Because of
likely inclusion of extended family members in asthma
management, we hypothesized that Island PR families
who report having an alternate caregiver would find it
less challenging to balance and integrate asthma into
daily life as compared with RI Latino and NLW families.
We also hypothesized that families who report having an
alternate caregiver would be rated as having lower medication
adherence owing to a greater diffusion of illness-related
responsibility.