Glorisa Canino

Publications (241) View all

• Article: Parental Numeracy and Asthma Exacerbations in Puerto Rican Children.

  Christian Rosas-Salazar, Sima K Ramratnam, John M Brehm, Yueh-Ying Han, Edna Acosta-Pérez, María Alvarez, Angel Colón-Semidey, Glorisa Canino, Andrea J Apter, Juan C Celedón
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  ABSTRACT: ABSTRACT BACKGROUND Puerto Ricans share a disproportionate burden of childhood asthma in the United States. Little is known about the impact of low parental numeracy (a health literacy skill) on asthma morbidity in Puerto Rican children. Our objective was to examine whether low parental numeracy is associated with increased asthma morbidity in Puerto Rican children. METHODS Cross-sectional study of 351 children with asthma, ages 6 to 14 years, living in San Juan, Puerto Rico. Parents of study participants completed a modified version of the Asthma Numeracy Questionnaire. Multivariate linear or logistic regression was used to examine the relation between low parental numeracy (defined as no correct answers in the modified Asthma Numeracy Questionnaire) and indicators of asthma morbidity (severe asthma exacerbations, core measures of asthma exacerbations, and lung function measures). All multivariate models were adjusted for age, gender, household income, reported use of inhaled corticosteroids in the previous six months, and exposure to second-hand tobacco smoke. RESULTS Low parental numeracy was associated with increased odds of visits to the emergency department or urgent care for asthma (adjusted odds ratio [aOR]=1.7, 95% confidence interval [CI]=1.03-2.7, P=0.04). The association between low parental numeracy and hospitalizations for asthma was significant only among children not using inhaled corticosteroids (aOR=2.8, 95%CI=1.4-5.6, P=0.004). There was no association between low parental numeracy and use of systemic steroids or lung function measures. CONCLUSIONS Low parental numeracy is associated with increased asthma morbidity in Puerto Rican children.
  Chest 03/2013; · 5.25 Impact Factor
• Article: Validation of the "World Health Organization Disability Assessment Schedule for Children, WHODAS-Child" in Rwanda.

  Pamela Scorza, Anne Stevenson, Glorisa Canino, Christine Mushashi, Fredrick Kanyanganzi, Morris Munyanah, Theresa Betancourt
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  ABSTRACT: The World Health Organization Disability Assessment Schedule for children (WHODAS-Child) is a disability assessment instrument based on the WHO's International Classification of Functioning, Disability and Health for children and youth. It is modified from the original adult version specifically for use with children. The aim of this study was to assess the WHODAS-Child structure and metric properties in a community sample of children with and without reported psychosocial problems in rural Rwanda. The WHODAS-Child was first translated into Kinyarwanda through a detailed committee translation process and back-translation. Cognitive interviewing was used to assess the comprehension of the translated items. Test-retest reliability was assessed in a group of 64 children. The translated WHODAS-Child was then administered to a final sample of 367 children in southern Kayonza district in rural southeastern Rwanda within a larger psychosocial assessment battery. The latent structure was assessed through confirmatory factor analysis. Reliability was evaluated in terms of internal consistency (Cronbach's alpha) and test-retest reliability (Pearson's correlation coefficient). Construct validity was explored by examining convergence between WHODAS-Child scores and mental disorder status, and divergence of WHODAS-Child scores with protective factors and prosocial behaviors. Concordance between parent and child scores was also assessed. The six-factor structure of the WHODAS-Child was confirmed in a population sample of Rwandan children. Test-retest and inter-rater reliability were high (r = .83 and ICC = .88). WHODAS-Child scores were moderately positively correlated with presence of depression (r = .42, p<.001) and post-traumatic stress disorder (r = .31, p<.001) and moderately negatively correlated with prosocial behaviors (r = .47, p<.001). The Kinyarwanda version of the WHODAS-Child was found to be a reliable and acceptable self-report tool for assessment of functional impairment among children largely referred for psychosocial problems in the study district in rural Rwanda. Further research in low-resource settings and with more general populations is recommended.
  PLoS ONE 01/2013; 8(3):e57725. · 4.09 Impact Factor
• Article: Ethnic differences in caregiver quality of life in pediatric asthma.

  Robin S Everhart, Daphne Koinis-Mitchell, Elizabeth L McQuaid, Sheryl Kopel, Ronald Seifer, Glorisa Canino, Gregory Fritz
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  ABSTRACT: : The aim of this study was to determine ethnic and site differences in quality of life (QOL) in a sample of Latino (Puerto Rican [PR] and Dominican) and non-Latino white caregivers of children with asthma in mainland US and Island PR. We also investigated ethnic and site differences in associations between caregiver QOL and indicators of asthma morbidity. : Seven hundred and eighty-seven children with asthma (7-16 years of age) and their primary caregivers participated in the study. Primary caregivers completed a measure of QOL, child asthma control, and emergency department utilization, among other measures. : Ethnic and site differences were found on total QOL scores ([INCREMENT]F(1,783) = 29.46, p < .001). Island PR caregivers reported worse QOL scores than Rhode Island (Rl) Latino and non-Latino white caregivers; Rl Latino caregivers reported significantly worse QOL scores than non-Latino white caregivers. In Rl Latino and Island PR children, worse caregiver QOL was associated with asthma that was not in control and with one or more emergency department visits. : Latino caregivers may be experiencing a greater level of burden related to their child's asthma than non-Latino white caregivers. Caregiver QOL in pediatric asthma may be a reflection of broader contextual stress that some Latino caregivers experience on a daily basis (e.g., cultural beliefs, acculturation). Future research should continue to investigate mechanisms that explain the burden associated with pediatric asthma in Latino families, as well as whether QOL assessments should consider the impact of everyday stressors on caregiver QOL in pediatric asthma.
  Journal of developmental and behavioral pediatrics: JDBP 10/2012; 33(8):599-607. · 2.27 Impact Factor
• Article: Family Influences on the Long Term Post-Disaster Recovery of Puerto Rican Youth.

  Erika Felix, Sukkyung You, Eric Vernberg, Glorisa Canino
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  ABSTRACT: This study focused on characteristics of the family environment that may mediate the relationship between disaster exposure and the presence of symptoms that met DSM-IV diagnostic criteria for symptom count and duration for an internalizing disorder in children and youth. We also explored how parental history of mental health problems may moderate this mediational model. Approximately 18 months after Hurricane Georges hit Puerto Rico in 1998, participants were randomly selected based on a probability household sample using 1990 US Census block groups. Caregivers and children (N = 1,886 dyads) were interviewed with the Diagnostic Interview Schedule for Children and other questionnaires in Spanish. Areas of the family environment assessed include parent-child relationship quality, parent-child involvement, parental monitoring, discipline, parents' relationship quality and parental mental health. SEM models were estimated for parents and children, and by age group. For children (4-10 years old), parenting variables were related to internalizing psychopathology, but did not mediate the exposure-psychopathology relationship. Exposure had a direct relationship to internalizing psychopathology. For youth (11-17 years old), some parenting variables attenuated the relation between exposure and internalizing psychopathology. Family environment factors may play a mediational role in psychopathology post-disaster among youth, compared to an additive role for children. Hurricane exposure had a significant relation to family environment for families without parental history of mental health problems, but no influence for families with a parental history of mental health problems.
  Journal of Abnormal Child Psychology 06/2012; · 3.09 Impact Factor
• Article: Medication adherence among Latino and non-Latino white children with asthma.

  Elizabeth L McQuaid, Robin S Everhart, Ronald Seifer, Sheryl J Kopel, Daphne Koinis Mitchell, Robert B Klein, Cynthia A Esteban, Gregory K Fritz, Glorisa Canino
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  ABSTRACT: Latino children of Caribbean descent remain at high risk for poorly controlled asthma. Controller medications improve asthma control; however, medication adherence remains suboptimal, particularly among minorities. This study assessed socioeconomic, family-based, and parent factors in medication adherence among children with asthma from Rhode Island (RI; Latino and non-Latino white [NLW]) and Puerto Rico. Data collection occurred as part of a multicenter study of asthma disparities. Our sample included children (ages 7-16) prescribed objectively monitored controller medications (n = 277; 80 island Puerto Rico, 114 RI Latino, 83 RI NLW). Parents completed questionnaires regarding family background and beliefs about medications. Families participated in an interview regarding asthma management. Multilevel analyses (maximum likelihood estimates) accounting for children being nested within site and ethnic group assessed the contribution of social context, family, and parent variables to medication adherence. Medication adherence differed by ethnic group (F(2, 271) = 7.46, P < .01), with NLW families demonstrating the highest levels of adherence. Multilevel models indicated that parental beliefs about medication necessity and family organization regarding medication use were significant predictors of adherence, even for families below the poverty threshold. With family factors in the model, a substantial improvement in model fit occurred (Akaike Information Criterion change of 103.45). Adherence to controller medications was lower among Latino children in our sample. Targeted interventions that capitalize on existing family resources, emphasize structure, and address parental beliefs about the importance of medications may be of benefit to families from different cultural backgrounds.
  PEDIATRICS 05/2012; 129(6):e1404-10. · 4.47 Impact Factor