Air Quality Index and Childhood Asthma: A Pilot Randomized Clinical Trial Intervention.
Air Quality Index and Childhood Asthma: A Pilot Randomized Clinical Trial Intervention.
复制标题
空气质量指数和儿童哮喘：试点随机临床试验干预。
DOI：
10.1016/j.amepre.2022.12.010
复制
发表时间：
2023
影响因子：
5.5
通讯作者：
Celedón,JuanC
中科院分区：
文献类型：
--
作者：
Rosser,FranziskaJ;Rothenberger,ScottD;Han,Yueh-Ying;Forno,Erick;Celedón,JuanC
简介 为了减少空气污染暴露，美国哮喘指南建议儿童在户外活动前检查空气质量指数。将空气质量指数和建议添加到哮喘行动计划中是否可以减少哮喘发作并改善哮喘儿童的控制和生活质量尚不清楚。方法 对从匹兹堡大学医学中心儿童医院（宾夕法尼亚州匹兹堡）招募的 40 名持续性哮喘儿童进行了一项试点、非盲法、随机临床试验，按年龄分层并按 1:1 随机化。所有参与者都接受了哮喘行动计划和空气质量指数教育。干预组收到打印的空气质量指数信息，并展示了使用 AirNow 的能力。通过问卷评估哮喘加重，通过哮喘控制测试和儿童哮喘控制测试评估哮喘控制，并通过小儿哮喘生活质量问卷评估生活质量。随机分组后（2020 年 7 月至 10 月），参与者每月接受一次随访，为期 6 个月（2021 年 1 月至 3 月退出）。在退出访视时和一段时间内评估各组之间的结果差异（分析于 2021 年进行）。结果 随机分组时，年龄、性别、种族或哮喘严重程度没有显着差异。在退出时，更多的干预参与者检查了空气质量指数（63% vs 15%），哮喘恶化的比例或平均儿童哮喘控制测试或小儿哮喘生活质量问卷得分没有差异。干预组的哮喘控制测试分数的平均变化较高（哮喘控制测试的变化= 2.00 vs 对照组的 0.15），并随时间进行修正（β= 1.85，CI= 0.09，3.61）。体力活动总体减少，并随治疗和时间的变化而变化。结论 将空气质量指数添加到哮喘行动计划中可以通过哮喘控制测试分数改善哮喘控制，但可能会减少户外活动。
Introduction To reduce air pollution exposure, the US asthma guidelines recommend that children check the Air Quality Index before outdoor activity. Whether adding the Air Quality Index and recommendations to asthma action plans reduces exacerbations and improves control and quality of life in children with asthma is unknown. Methods A pilot, unblinded, randomized clinical trial of 40 children with persistent asthma, stratified by age and randomized 1: 1, recruited from the University of Pittsburgh Medical Center Children's Hospital of Pittsburgh (Pittsburgh, PA) was conducted. All participants received asthma action plans and Air Quality Index education. The intervention group received printed Air Quality Index information and showed the ability to use AirNow. Asthma exacerbations were assessed through a questionnaire, asthma control was assessed with the Asthma Control Test and Childhood Asthma Control Test, and quality of life was assessed with the Pediatric Asthma Quality of Life Questionnaire. After randomization (July–October 2020), participants were followed monthly for 6 months (exit January–March 2021). Outcome differences between groups were evaluated at the exit visit and over time (analysis was in 2021). Results At randomization, there were no significant differences in age, sex, race, or asthma severity. At exit, more intervention participants checked the Air Quality Index (63% vs 15%) with no differences in the proportion of asthma exacerbations or mean Childhood Asthma Control Test or Pediatric Asthma Quality of Life Questionnaire scores. The mean change in Asthma Control Test score was higher in the intervention group (change in Asthma Control Test= 2.00 vs 0.15 for the control), which was modified by time (β= 1.85, CI= 0.09, 3.61). Physical activity was decreased overall and showed modification by treatment and time. Conclusions Addition of the Air Quality Index to asthma action plans led to improved asthma control by Asthma Control Test scores but may decrease outdoor activity.