Parents in fragile families: The influence of parental engagement on emergency care use in children with asthma

Current research focused on stress responsive illnesses such as asthma has identified a crucial role for families in the progression and maintenance of stress responsive illnesses. What is currently not clear is the differential effect of maternal versus paternal engagement in the management of pediatric asthma. This study explores whether or not mother, father, or the combined engagement has an effect on the management of pediatric asthma. A subsample of the Fragile Families Child and Wellbeing Study (FFCW Study) was used to examine the role of parental engagement (n = 475; 41.9% female, 58.1% male). Path analysis and actor partner interdependence modeling processes were used to examine the differential effect of mother and father engagement. A final nested model with only direct effects from the father's level of engagement proved to be the best fitting model, X²(9) = 16.738, p = .05298, CFI = 0.995, GFI = 0.989, RMSEA = 0.043. Within this model father engagement had a moderating effect for child's emergency room (ER) use (β = -.124, p < .05). The mother's effect was best modeled as an indirect effect as this increased the father's level of engagement, but did not have a direct effect on the outcome of ER usage. This study is consistent with other studies that found that the predictability of a father's role and routine had positive health outcomes for the asthmatic child. Implications for future research and practice are identified and discussed.