Table 4.
Adjusted associations of illness and medication beliefs with self-management behaviors of World Trade Center rescue and recovery workers with asthma.
| Belief | Medication adherence OR (95% CI) | Correct MDI technique OR (95% CI) | Correct DPI technique OR (95% CI) | Action plan use OR (95% CI) | Trigger avoidance OR (95% CI) |
|---|---|---|---|---|---|
| Asthma labels | |||||
| Wheezing due to asthma | 1.16 (0.52–2.58) | 1.3 (0.54–3.14) | 0.41 (0.02–7.75) | 3.83 (0.66–22.11) | 1.96 (0.99–3.89) |
| Tiredness due to asthma | 1.11 (0.65–1.91) | 1.28 (0.67–2.44) | —* | 1.83 (0.57–5.92) | 1.4 (0.86–2.27) |
| WTC-related asthma is different from non-WTC-related asthma | 1.39 (0.84–2.31) | 0.85 (0.47–1.54) | 0.94 (0.13–6.85) | 2.78 (0.89–8.69) | 1.09 (0.69–1.73) |
| Cause | |||||
| Timeline | |||||
| Asthma due to WTC exposure | 1.82 (0.52–6.36) | 0.61 (0.12–3.04) | —* | 1.91 (0.08–44.41) | 3.89 (1.11–13.58) |
| Asthma due to inadequate respiratory protection at WTC site | 2.37 (1.38–4.08) | 1.17 (0.62–2.21) | 1.44 (0.18–11.22) | 4.33 (1.08–17.28) | 1.27 (0.77–2.08) |
| Control | |||||
| WTC-related asthma is more severe | 1.73 (1.02–2.93) | 0.93 (0.51–1.73) | 0.39 (0.04–3.57) | 1.64 (0.5–5.37) | 1.25 (0.78–2.01) |
| Doctors do not know how to treat WTC asthma | 0.81 (0.43–1.53) | 0.77 (0.36–1.67) | 2.29 (0.1–53.39) | 1.68 (0.37–7.61) | 0.8 (0.43–1.46) |
| Consequences | |||||
| Asthma affects my life | 1.3 (0.77–2.19) | 0.88 (0.47–1.65) | 2.42 (0.26–22.89) | 2.38 (0.73–7.74) | 1.78 (1.09–2.93) |
| Experience lot of asthma symptoms | 0.7 (0.4–1.24) | 1.77 (0.82–3.82) | —* | 1.92 (0.51–7.16) | 0.88 (0.51–1.5) |
| Emotional responses | |||||
| Concerned about asthma | 1.26 (0.72–2.21) | 0.93 (0.49–1.77) | 0.93 (0.1–8.45) | 1.2 (0.33–4.37) | 1.45 (0.89,2.36) |
| Asthma affects emotionally | 1.54 (0.84–2.83) | 0.5 (0.25–0.98) | 4.74 (0.15–145.52) | 1.27 (0.38–4.23) | 1.94 (1.12–3.36) |
| Worried asthma may get worse | 1.45 (0.78–2.7) | 0.6 (0.29–1.24) | 1.55 (0.14–17.24) | 2.2 (0.55–8.89) | 1.31 (0.75–2.29) |
| Medication beliefs | |||||
| Necessity | |||||
| Important to use medications when not having symptoms | 12.76 (5.51–29.53) | 1.5 (0.74–3.07) | 0.94 (0.06–14.15) | 0.62 (0.11–3.44) | 1.72 (0.93–3.18) |
| Feel effects of inhaled corticosteroids | 1.93 (1.08–3.43) | 0.92 (0.48–1.76) | 0.66 (0.06–7.76) | 0.32 (0.08–1.33) | 1.42 (0.87–2.33) |
| Only need SABA to treat asthma | 0.45 (0.26–0.77) | 1.07 (0.57–2.02) | 0.39 (0.04–3.42) | 1.33 (0.38–4.64) | 0.56 (0.33–0.93) |
| Present health depends on medicine | 2.39 (1.39–4.13) | 1.45 (0.73–2.88) | 4.82 (0.35–67.01) | 2.88 (0.64–12.87) | 1.17 (0.67–2.05) |
| Concerns | |||||
| Inhaled steroids weaken immunity | 1.35 (0.76–2.38) | 0.74 (0.39–1.4) | 0.75 (0.04–15.51) | 2.9 (0.72,11.63) | 1.18 (0.7–1.98) |
| Medications do not work as well for WTC asthma | 0.8 (0.4–1.6) | 1.09 (0.46–2.56) | 0.49 (0.03–8.72) | 1.27 (0.29–5.47) | 1.05 (0.56–1.99) |
| Self-efficacy | |||||
| Confident in ability to control asthma | 1.36 (0.72–2.61) | 2.1 (1.01–4.36) | 2.47 (0.24–25.37) | 0.47 (0.09–2.34) | 0.95 (0.51–1.76) |
OR: Odds ratio for adherence to asthma self-management behavior for those with vs. without the belief; CI: confidence interval; MDI: Metered Dose Inhaler; DPI: Dry Powder Inhaler; WTC: World Trade Center; SABA: Short-Acting Beta-Agonist.
*
Unable to fit model due to complete separation of data.