Date of Award

Spring 2000

Document Type


Degree Name

Doctor of Philosophy (PhD)


Urban Services--Health Services

Committee Director

Brenda Nichols

Committee Member

J. Echternach

Committee Member

D. Thomas

Committee Member

Clare Houseman

Committee Member

Lindsay Rettie


To ensure culturally-sensitive assessments, the researcher designed a Pediatric Breathing Survey (PBS) to measure quality of life for African-American children. The purpose of this study was to test whether the PBS is a reliable and valid instrument. Comparisons of group differences on race, income and parent's level of education based on parent responses to the questionnaires were conducted. More specifically, differences in Health Related Quality of Life (HRQOL) between Caucasian and African-American children were examined. The researcher-designed instrument was compared to Juniper's Pediatric Asthma Quality of Life Questionnaire. The sample consisted of parents of 84 school-aged children diagnosed with asthma.

It was hypothesized that the PBS would consist of four dimensions of HRQOL: the physical and disease dimension, the psychological dimension, social dimension and the traditional health belief dimension. The traditional health belief domain was added to the PBS and consisted of 11 questions relevant to African-American cultural beliefs and traditions. A factor analysis of the PBS in this sample supported only two domains, the emotional and physical dimensions. Juniper's PAQOLQ was designed to address three domains (physical, emotional and social impairments); the factor analysis for this study supported only one dimension. Both questionnaires (PBS and Juniper's Pediatric Asthma Quality of Life) were reliable and valid.

MANOVA and ANOVA analyses were done to determine group differences on the variables of income, race and educational level. This analysis revealed only the factor of income differed between the two instruments. There was no significant statistical difference found for educational level or race. A chi-square analysis was also done on the traditional health belief domain. The chi square analysis revealed a significant difference based on parent's educational level, race and income for the traditional health belief domain question, “I have the money for all my medicine for asthma.” The difference in the two HRQOL instruments is the addition of the traditional health belief domain. This domain reveals a holistic picture of the asthmatic child's living arrangement. The total environment of the subject must be taken into account to adequately assess HRQOL (Burke et al, 1997). The addition of the traditional health belief domain enhances further asthma intervention programs because the patient's total environment is taken into account. The PBS may be a better HRQOL questionnaire for use in the United States. The questionnaire includes questions pertinent to the financial status and living arrangements of the asthmatic child's parents.