Why are children with asthma bullied? A quantitative analysis of bullying risk factors in the Room to Breathe cohort

Abstract

Background: Bullying and asthma are common challenges faced by children worldwide. It has been shown that children with chronic health conditions are at higher risk of being bullied, but this has not been explored in detail in asthma. Aims and Objectives: To determine what child/parent factors and attitudes are associated with increased asthma related bullying risks. Methods: The Room to Breathe1 survey parental and child responses (n=943) were analysed to examine the relationship between asthma control, activity restriction and parental concern and bullying. All analyses were undertaken using STATA statistical software (v14.0). Results: 1 in 10 children reported being “made fun of, or bullied because of their asthma” (n=93). Being a victim of asthma related bullying was associated with poorer asthma control (p=0.0001; 95% CI 1.44, 3.60), child perceived asthma control (p=0.0000; 95% CI 1.85, 4.84), activity restriction (p=0.0095; 95% CI 1.11, 2.77) and parental worry (p=0.0248; 95% CI 1.03, 2.57). Bullying was not statistically significantly associated with parent’s perceived asthma control, parental worry regarding use of steroids, or spacer use in public. Conclusion: Bullying in asthma is strongly associated with control, as perceived by the child and by validated control score, as well as activity restriction and parental worry. However, bullying is not associated with parental perception of control. Parent-reported data may be misrepresentative of bullying rates and asthma control. Asthma consultations must be child-focussed in order to gain a representative appreciation of asthma control and its impact on life.