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Health Education & Behavior, Vol. 26, No. 1, 55-71 (1999)
DOI: 10.1177/109019819902600106

Self-Regulating Childhood Asthma: A Developmental Model of Family Change

Barry J. Zimmerman, PhD

Doctoral Program in Educational Psychology at the City University of New York Graduate Center, New Yorkbzimmerm{at}email.gc.cuny.edu

Sebastian Bonner, PhD

Columbia University, New York

David Evans, PhD

Clinical Public Health in the School of Public Health at Columbia University College of Physicians and Surgeons, New York

Robert B. Mellins, MD

Pediatrics at Columbia University College of Physicians and Surgeons, New York

This article tests a model of self-regulatory development in which families’cognitive beliefs and behavioral skills for managing asthma symptoms emerge in four successive phases: asthma symptom avoidance, asthma acceptance, asthma compliance, and asthma self-regulation. Confirmatory factor analyses revealed that the hypothesized multiphase model provided the best factorial fit for phase items. Subsequent Guttman analyses of the families’phase scores revealed a high degree of sequential ordering. Finally, trend analyses of family phase differences revealed a significant negative linear relation with measures of asthma severity and a significant positive linear relation with physician care and concern measures, asthma regulatory measures, and beliefs in Western biomedical practices. Despite receiving primary care for asthma at a major metropolitan university hospital, 83% of the sample were classified as precompliant. The phase model of asthma self-regulatory development offers a qualitative approach for investigating the psychological determinants of asthma self-regulatory behavior.


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