The relationship between knowledge and reported behavior in childhood asthma

Numerous educational interventions have been developed and tested to improve management of childhood asthma. Most programs assume that knowledge about asthma is related to initiating and/or maintaining recommended management behaviors. Although this assumption is widely accepted, some available evidence casts doubt upon its validity. We investigated the relationship between asthma management behaviors and (1) knowledge about asthma, (2) behavioral adjustment, (3) anxiety, and (4) health locus of control. Data were collected on 91 children 7 to 12 years of age with moderately severe asthma. After adjusting for covariates, reported asthma management behavior was significantly related only to knowledge about asthma (p <.05). The relationship between knowledge and behavior is nonlinear: Accurate knowledge is related to engaging in more of the recommended behaviors, but only up to a moderate level of knowledge. Also, the relationship between knowledge and asthma management behavior was especially strong for children who scored lower on behavioral adjustment. These results suggest that children's knowledge about asthma can influence behavior, but only under certain conditions. Educational interventions for children whose knowledge is already adequate may not increase adherence to recommended practices.