Robin S. Everhart received the inaugural Targeted Research Grant for her research, “ Using ecological momentary assessment to examine caregiver burden related to pediatric asthma in urban families.” Everhart is in her second year as an assistant professor in the Department of Psychology at Virginia Commonwealth University (VCU). Prior to her position at VCU, Everhart was a postdoctoral fellow at Rhode Island Hospital/Brown Medical School and completed an F32 study focused on family and cultural factors related to caregiver quality of life (QOL) in pediatric asthma under the direction of Daphne Koinis Mitchell (F32HL104889).

The goal of Everhart's SPP Targeted Research Grant is to use a novel assessment strategy , ecological momentary assessment (EMA) delivered via smartphones, to further understanding of the daily burden associated with caring for a child with asthma among 60 urban caregivers from Latino, African-American, and non-Latino White backgrounds. Given that a higher proportion of ethnic and racial minority families reside in urban settings, factors related to urban living (e.g., neighborhood stress) and cultural factors (e.g., medication beliefs) may affect caregiver QOL and subsequent decisions about pediatric asthma care. Results from a study by Everhart and colleagues (2012) suggest that Latino caregivers may experience a greater level of burden related to their child's asthma than non-Latino White caregivers. Further, these differences may be a reflection of broader contextual stress that some ethnic minority caregivers may experience on a daily basis. This study will use EMA to identify targets of interventions to improve QOL in urban caregivers with a child with asthma (between 7 and 12 years of age) and addresses the SPP Targeted Research Grant priority area: studies of novel measurement/ assessment strategies . Everhart will work closely with an EMA consultant, Kristin Heron, Associate Director of the Dynamic Real-time Ecological Ambulatory Methodologies (DREAM) program at the Penn State Survey Research Center, on the current study.

The current study will first examine associations between caregiver QOL and cultural, family-level, caregiver-level, and asthma-related factors experienced in everyday life in a sample of 60 urban caregivers from Latino, African American, and non-Latino White backgrounds, as well as evaluate differences in these associations across racial and ethnic groups. Caregivers and children will complete interview-based assessments in a baseline session, including a measure of caregiver QOL. Following the baseline session, caregivers will respond to EMA survey items on smartphones for 14 days, completing surveys in the morning and the evening. EMA survey items are designed to assess daily factors including social support, caregiver mood, family stress, use of alternative treatments, and secondhand smoke exposure, among other factors. Children will also use an AM2 spirometer twice a day for the two weeks to measure lung functioning.

The second phase of the study will explore the impact of an individualized EMA feedback condition on caregiver QOL as compared to a control condition. Everhart will also evaluate the feasibility of implementing an in-person intervention that is tailored based on EMA collected via smartphones. After completing the 2 week EMA surveys, caregivers will be randomized to either the feedback (30 caregivers) or control condition (30 caregivers). Caregivers randomized to the feedback condition will receive individualized feedback related to their EMA surveys (e.g., factors associated with caregiver QOL) during a strategy building session. Caregivers in the control condition will receive information related to general child health. Caregivers in both conditions will generate tailored strategies for improving these areas (either caregiver QOL or child health) and use these strategies for 4 weeks. Follow-up assessments of caregiver QOL will occur at 4 weeks after the strategy building session and 3 months later. Results from this study will be used to develop a tailored intervention to improve QOL in urban caregivers with a child with asthma that can be delivered as part of an ecological momentary intervention (EMI) with intervention components delivered via smartphones.