Hyekyun Rhee

• Doctor of Philosophy
• Professor at University of Texas at Austin

Background/Objectives: Puerto Ricans (PRs) face significant challenges in accessing essential parenting resources and support due to language barriers and lack of culturally appropriate healthcare services, perpetuating health disparities. Cultural adaptation of psychosocial measurement tools is crucial for promoting health equity and improving hea...

Background Intimate partner violence (IPV) is a significant public health concern, particularly in vulnerable populations such as Chinese immigrant women. Aim This study aimed to assess the feasibility and acceptability of an empowerment-based intervention integrated with relaxation and self-compassion techniques for Chinese immigrant women experi...

Background Hypertension (HTN) is the leading cause of cardiovascular disease morbidity and mortality worldwide. Despite effective treatments, most people with HTN do not have their blood pressure under control. Precision health strategies emphasizing predictive, preventive, and personalized care through digital tools offer notable opportunities to...

Background Youth who experience homelessness engage in behaviors that place them at high risk for disease and injury. Despite their health risk behaviors, these youth display psychological capital, positive attributes of hope, efficacy, resilience, and optimism that motivate them to engage in health-promoting behaviors such as safer sex. However, t...

Chinese immigrant survivors of men’s violence experience both significant mental health impacts from abuse and barriers to formal services. Therefore, we examined the preliminary efficacy of an innovative mobile-based empowerment-based intervention (self-compassion, health, and empowerment; SHE) that specifically focuses on abused Chinese immigrant...

Adolescence marks a significant transition from pediatric to adult healthcare, and parents play critical roles in supporting their adolescents with chronic conditions through this process. However, little is known about parents’ experiences, perceptions, and needs during this healthcare transition. This qualitative study explores the experiences an...

This qualitative descriptive study explores experiences and perspectives of mid-to-late adolescents about growing up with asthma, and the roles of parents and providers as they transition. Purposeful sampling was used to recruit and enroll adolescents aged 16–20 years with asthma. Forty-one adolescents participated in a focus group or individual in...

Objective: Asthma is the leading chronic health condition in adolescents, yet little is known about adolescents’ readiness to transition into adult-focused care. This study examines transition readiness in middle and late adolescents with asthma. Methods: This cross-sectional descriptive study was conducted in 2019 with 41 adolescents (16 to 20 yea...

Background Nurse scientists have significantly contributed to health equity and ensuring cultural tailoring of interventions to meet unique needs of individuals. Methodologies for cultural tailoring of self-mangament interventions among marginalized populations have limitedly accommodated intersectionality and group heterogeneity when addressing he...

Problem Adolescent survivors of cancer face an increased risk of chronic health conditions that can be improved by healthy behaviors. The purpose of this review is to synthesize the extent/prevalence of health behaviors (physical activity [PA], diet, human papillomavirus [HPV] vaccination, alcohol use, smoking, marijuana use, and unprotected sex) c...

Objective: To characterize adolescents' practical knowledge of asthma self-management and experiences during acute asthma episodes, and compare practical knowledge between minority and non-minority groups. Methods: We conducted a secondary analysis using a qualitative descriptive design of textual data collected from 126 adolescents that partici...

Background Accurate assessment of asthma symptoms is central to appropriate treatment and management; however effective communication about symptoms−how it is perceived and reported−remain challenging in pediatric clinical and research settings. Objective To synthesize the existing pediatric literature on children's and adolescents’ word descripto...

Importance Long-term effectiveness of a peer-led asthma self-management program in improving asthma outcomes in adolescents living in urban areas has not been established. Objective To determine the long-term effects of a peer-led program on asthma control, quality of life, and asthma management among predominantly racial and ethnic minority adole...

Collecting accurate healthcare utilization (HCU) data on community‐based interventions is essential to establishing their clinical effectiveness and cost‐related impact. Strategies used to enhance receiving medical records for HCU data extraction in a multi‐site longitudinal randomized control trial with urban adolescents are presented. Successful...

Objective To examine the long-term effects of a peer-led asthma self-management program on urban adolescent peer leaders with asthma. Methods This longitudinal study includes 51 adolescents (16−20 years) enrolled in an asthma self-management program implemented at a one-day camp as peer leaders. Study outcomes, including quality of life, asthma co...

Objective This study examines the relationships between three measures of asthma related self-efficacy and compares them by their relationships to quality of life, medication adherence, asthma control, asthma knowledge, and attitudes in adolescents. Methods Participants included 371 urban adolescents (age 12-20 years) with asthma. Three self-effic...

In this paper we compare the fidelity of a Peer‐Led Asthma Self‐Management Program for Adolescents (PLASMA) and its attention control. A randomized controlled trial involving two groups—the PLASMA group and the attention control group—was conducted between 2015 and 2018. Adolescents 12–17 years old (N = 259) in three cities in the United States rec...

Objective: Adolescents with asthma are influenced by peers and family. The objective was to better understand family social support and test its association with medication adherence, asthma control, and Emergency Department (ED) use. Methods: This study is a cross-sectional secondary data analysis from a randomized controlled trial with urban adol...

Objective: To examine the prevalence of overweight and obesity in urban adolescents with asthma and to investigate the relationships between anthropometric measures and asthma outcomes including quality of life, asthma control and lung function. Methods: Adolescents with an asthma diagnosis, 12-20 years-old, were recruited from three urban communit...

Purpose: This paper describes the acceptability and generalizability of an evidenced-based peer-led asthma self-management program. Design and methods: Adolescents with persistent asthma (n = 259, ages 12-17 years) from three urban cities participated in a one day camp led by either trained peer leaders (n = 35, ages 16-20 years; intervention gr...

Background: Urban adolescents suffer a disproportionate burden of asthma morbidity, often in association with allergies. Literature is limited on comparing various types of allergies regarding prevalence and associations with asthma morbidity in urban dwelling adolescents. The purpose of this study was to examine the prevalence of common allergies...

Objectives: Asthma is the most common chronic disease of childhood in the United States, disproportionately affecting urban, poor, and minority children. Adolescents are at high risk for poor asthma outcomes and for depressive symptoms. The purpose of this study is to investigate associations between depressive symptoms and asthma-related clinical...

Background: Adequate assessment of control is critical to asthma management. The Asthma Control Questionnaire (ACQ) and the National Asthma Education and Prevention Program (NAEPP) criteria are commonly used measures of asthma control. Objective: This study is to examine the relationships between the ACQ and NEAPP criteria and compare the validi...

Background Accurate symptom assessment remains challenging in teen populations. Little is known of usual symptom/response patterns, and self‐reported paper diaries have traditionally low compliance rates. Therefore, we used concurrent digital voice‐diaries to capture daily asthma experiences. Objective (1) To qualitatively explore usual symptom pa...

Purpose Adolescents with asthma often report poor medication adherence and asthma control. Cognitive factors embedded in the social cognitive theory including self-efficacy, outcome expectations, and barrier perceptions may explain poor asthma outcomes in this population. This study was performed to examine the extent to which these cognitive facto...

Background: Sputum neutrophils are associated with severe asthma, poor pulmonary function and high body mass index (BMI) in adult patients. However, little is known about the relationships between blood neutrophils, BMI and asthma severity in pediatric patients. This brief report is to assess the predictive value of blood neutrophils for asthma se...

Intervention studies with urban adolescents and families affected by asthma are critical to improving the disproportionate morbidity in this population. Community-based recruitment and retention strategies in a multi-site longitudinal project evaluating an asthma self-management intervention for adolescents are presented. Successful recruitment str...

Objectives: A previous definition of adolescent asthma self-management was derived from interviews with clinicians/researchers and published literature; however, it did not incorporate perspectives of teens or parents. Therefore, we conducted in-depth interviews with teens and parents and synthesized present findings with the prior analysis to dev...

Background: Success in asthma management hinges on patients' competency to detect and respond to ever-changing symptom severity. Thus, it is crucial to have reliable, simple, and sustainable methods of symptom monitoring that can be readily incorporated into daily life. Although visual analogue scale (VAS) has been considered as a simple symptom a...

Objective: To evaluate efficacy of a developmentally sensitive curriculum for improving asthma self-management knowledge, attitude, and self-efficacy in adolescents. Methods: Fourty-two inner-city adolescents (ages 16-20) participated in a 12hour asthma self-management training program. Self-management knowledge, attitude toward asthma, and asth...

Objectives: To examine interpersonal relationships involving peers and teachers and perceptions about school environment among middle school students with asthma in comparison to their healthy counterparts. The study also assesses asthma prevalence in a large sample of middle school students representing different geographic locations. Methods: Cro...

Background: Teens often have inadequate asthma self-management and control. However, little is known of their perceptions of or rationales for self-management behaviors. Objectives: To explore how teens self-manage asthma, including experiences, perceptions, responses to and reporting of symptoms. Methods: A case-based, qualitative-descriptive...

Background: Ability to elicit individuals' perceptions of complex behavioral processes can be challenging, as it hinges not only upon the skill of the researcher, but also upon assumptions of a shared language and individuals' ability to recall, analyze, and effectively communicate events. In a case-based qualitative-descriptive study about teens'...

Background: Symptom monitoring is a cornerstone of asthma self-management. Conventional methods of symptom monitoring have fallen short in producing objective data and eliciting patients' consistent adherence, particularly in teen patients. We have recently developed an Automated Device for Asthma Monitoring (ADAM) using a consumer mobile device a...

To examine the inter-relationships among body mass index (BMI), physical activity, sedentary behavior and gender in urban, low-income, primarily African American young adolescents with or without lifetime asthma. Data were collected in 2002-2004 from 626 12-year old adolescents who were children of women who participated in the New Mother's Study i...

The development of an Automated System for Asthma Monitoring (ADAM) is described. This consists of a consumer electronics mobile platform running a custom application. The application acquires an audio signal from an external user-worn microphone connected to the device analog-to-digital converter (microphone input). This signal is processed to det...

An automated system for monitoring respiratory diseases, such as asthma, provides noninvasive, multimodal monitoring of respiratory signs and symptoms that can include wheeze and cough. Some embodiments employ a mobile device, such as a cell phone, in which raw data from a microphone and an accelerometer are processed, analyzed, and stored. Data ca...

Background: Many adolescents suffer serious asthma related morbidity that can be prevented by adequate self-management of the disease. The accurate symptom monitoring by patients is the most fundamental antecedent to effective asthma management. Nonetheless, the adequacy and effectiveness of current methods of symptom self-monitoring have been cha...

Purpose Adolescents report high asthma-related morbidity that can be prevented by adequate self-management of the disease. Therefore, there is a need for a developmentally appropriate strategy to promote effective asthma self-management. Mobile phone-based technology is portable, commonly accessible, and well received by adolescents. The purpose of...

This study was to describe symptoms, feelings, activities and medical use reported by adolescents with uncontrolled asthma on their 24-hour asthma diaries. Adolescents with uncontrolled asthma (13-17years, N=29) completed asthma diaries and audio-recorded symptom sounds for 24hours. A variety of symptoms were reported, and the most frequently repor...

BACKGROUND: Adolescents with asthma have a higher risk of morbidity and mortality than other age groups. Asthma self-management has been shown to improve outcomes; however, the concept of asthma self-management is not explicitly defined. METHODS: We use the Norris method of concept clarification to delineate what constitutes the concept of asthma s...

Frequent use of health-care services associated with pediatric asthma places substantial economic burden on families and society. The purpose of this study is to examine the cost-saving effects of a peer-led program through reduction in health-care utilization in comparison to an adult-led program. Randomly assigned adolescents (13-17 years) partic...

Background: Asthma is the leading chronic condition in adolescents. Nonetheless, research efforts to address adolescent asthma morbidity by applying a developmentally appropriate self-management intervention have been limited. Recently a peer-led asthma self-management program has been developed and implemented for adolescents. The purpose of the...

To evaluate the effectiveness of a peer-led asthma self-management program for adolescents. Randomized controlled trial comparing a peer-led asthma program (intervention group) and a conventional adult-led asthma program (control group). Each program was implemented at a full-day camp. A city and adjacent suburbs in upstate New York. A total of 112...

Pediatric asthma is accountable for a substantial use of health care services. The purpose of this study was to systemically examine the extent to which inaccurate perception of asthma symptoms is associated with the use of health care services. This exploratory study included 126 adolescents with asthma who were between 13 and 20 years of age. Sub...

Asthma morbidity in children is associated with family psychosocial functioning. Although the family plays a pivotal role in maintaining optimal asthma care, the mechanism of how family support influences asthma outcomes is not well understood. The purpose of this study was to examine the role of barriers to adherence in mediating the effect of fam...

Rural adolescent females are at-risk for smoking at rates nearly equal to those of boys, and girls are at increased risk for smoking related diseases, reproductive, and pregnancy problems. The purpose of this study was to investigate protective factors related to nonsmoking in African American (AA) and Caucasian American (CA) female adolescents res...

Asthma morbidity in adolescents often results from inadequate asthma self-management. This study was to explore barriers to self-management perceived by adolescents and to examine the associations between barriers and psychosocial factors including knowledge, attitude and self-efficacy. This cross-sectional study included a total of 126 adolescents...

Although a high prevalence of substance use and its adverse effects on the course of the disease have been reported in adolescents with asthma, no studies have attempted to ameliorate the risk through adequate interventions. This pilot study evaluates and supports the feasibility and the effectiveness of a decision-making program in improving decis...

Although adolescents ultimately make their own decisions to smoke or not to smoke, social, economic, and environmental circumstances shape their choices. Most research on prevention of youth tobacco use focuses on predictors of smoking initiation. In this study, we explored nonsmoking attitudes, beliefs, and norms from the perspective of 16-17-year...

This paper explores specific challenges in implementing community-based group interventions with adolescents and makes practical suggestions to researchers who contemplate the group approach. Group interventions have important implications for adolescent research and program development in the area of chronic illness. They have a capacity to addres...

The purpose was to identify and describe the patterns of asthma control perception in relation to actual symptom reports in adolescents and to compare the group with accurate control perception with those of inaccurate perception in relationship to sociodemographic characteristics, illness-related factors, and psychosocial factors. A sample of 126...

Computer-assisted approaches hold great potential for research and interventions with rural adolescents with asthma. Geographical remoteness of populations has been a barrier in conducting research with rural populations. One possible solution is through the use of online communication. Information technology is well accepted by most children and a...

Asthma is a common chronic condition in adolescents. Despite chronic health conditions, adolescents are at great risk for substance-using risk behaviors such as smoking, alcohol use, and illicit drug use. Adolescents' decision-making quality may influence their risk behaviors. To date little is known about the extent to which rural adolescents with...

Asthma is influenced by and influences psychosocial experiences in adolescents. Therefore, the purpose of this study was to explore psychosocial experiences and coping strategies of a sample of adolescents with asthma based on their own accounts. Six focus group interviews were conducted in Central Virginia with 19 adolescents with asthma ages 12 t...

To identify particular learning needs among adolescents with asthma and explore the potential utility of the Internet in addressing adolescents' expressed learning needs. In 2004 and 2005, 6 gender-specific and age-specific focus groups were conducted among adolescents, ages 12-18 years, with mild intermittent to severe persistent asthma. Thematic...

Physical symptoms are common in otherwise healthy adolescents. This study sought to identify meaningful patterns of multiple physical symptoms and to examine relationships between the patterns and psychosocial factors. One-year stability of symptom patterns and factors contributing to stability were also examined. This secondary data analysis used...

To estimate the prevalence of 10 recurrent physical symptoms and to examine how prevalence differs by gender and age in healthy American adolescents. Cross-sectional analysis used survey data from the National Longitudinal Study of Adolescent Health (Add Health), a school-based probability sample of over 20,000 adolescents in grades 7 through 12. H...

This study was conducted to establish race/ethnic-specific prevalence for 10 physical symptoms in American youths and to examine the extent to which socioeconomic status and depressive symptoms explained racial differences in those symptoms. This descriptive study was based on a cross-sectional analysis of survey data from Wave I of the National Lo...

The purpose of this study was to examine relationships between physical symptoms and pubertal status and timing in adolescents. This descriptive study was based on cross-sectional analysis of survey data from the National Longitudinal Study of Adolescent Health including a school-based sample of more than 20,000 adolescents in grades 7 through 12....

This chapter summarizes and critiques research on physical symptoms in children and adolescents from a developmental science perspective. Studies conducted by researchers from various disciplines, primarily after 1990, were identified through searches of MEDLINE, CINAHL, and Psyc INFO. This review focuses on two areas: the prevalence of common phys...

Unlabelled: This study examined physical, behavioral and social factors associated with schoolchildren's back pain. Factors associated with back pain were also identified using a stepwise regression method. The study was based on a self-administered questionnaire survey of a random national sample of 2173 Icelandic 11-12 and 15-16-y-old schoolchil...

Functional headache, by definition, is a headache not associated with organic diseases. It is a common symptom in school children and can cause potentially serious health problems, affecting their growth and development. Therefore, this report synthesizes the literature about functional headaches in schoolchildren from a psychosocial perspective. T...

To examine the prevalence of headaches among US adolescents; to explore the differences in prevalence by sex, race, and age; and to test the nature of the association between headaches and depression, self-esteem, and insomnia. This longitudinal study used a nationally representative sample of adolescents (n = 6072) who were interviewed in 1995 (wa...