Evaluation of a HEPA Filter Pilot Project: Formative Data to Support a Future Indoor Air Quality Bronchiolitis Clinical Trial

HEPA 过滤器试点项目的评估：支持未来室内空气质量毛细支气管炎临床试验的形成性数据

• 批准号: 10411690
• 负责人: Matthew J Hirschfeld
• 金额: $ 0.83万
• 依托单位: ALASKA NATIVE TRIBAL HEALTH CONSORTIUM
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-23 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10411690
• 关键词: Acute; Address; Adult; Age-Months; Airway Disease; Alaska; Alaska Native; American Indians; Area; Bronchiectasis; Bronchiolitis; Characteristics; Child; Child Health; Childhood; Childhood Asthma; Chronic; Chronic lung disease; Clinical Trials; Clinical Trials Network; Complement; Data; Data Analyses; Education; Evaluation; Family; Frequencies; Future; Grant; Health; Home; Hospitalization; Household; Indoor Air Pollution; Indoor Air Quality; Internships; Inupiat; Life; Link; Lung; Lung diseases; Medical; Medical Students; Medicine; Mentors; Multi-Institutional Clinical Trial; Native-Born; Outcome; Particulate; Particulate Matter; Pilot Projects; Placebos; Protocols documentation; Qualitative Evaluations; Research; Research Personnel; Respiratory Signs and Symptoms; Respiratory Tract Infections; Rural; Services; Severities; Site; Smoke; Symptoms; Tobacco; Training; United States National Institutes of Health; Wood stove; Writing; Yukon Kuskokwim; Yukon-Kuskokwim Delta; Yup' ik; air filtration; data format; efficacy evaluation; experience; high efficiency particulate air filter; improved; portability; programs; randomized trial; tobacco smoke exposure; tobacco smokers; tribal health; ventilation

PROJECT SUMMARY/ABSTRACT Alaska Native and American Indian (ANAI) children experience a high burden of acute and chronic respiratory disease. Wood stove use, poor ventilation, and indoor tobacco smoke exposure have all been shown to cause poor indoor air quality (IAQ), which is associated with increased severity and frequency of respiratory infections in children. Portable HEPA purifiers have been shown to be effective in reducing particulate matter from tobacco and nontobacco smoke; however, despite demonstrated links between early-life severe respiratory infections, pediatric asthma, and adult pulmonary outcomes, no randomized trials to improve IAQ and associated health outcomes in children with bronchiolitis have been conducted. The IDeA States Pediatric Clinical Trials Network (ISPCTN) is developing a protocol for a clinical trial to address this gap. The proposal, “Reduction of indoor air pollution with high efficiency particulate air (HEPA) filtration to decrease respiratory symptom burden after hospitalization for bronchiolitis (IAQ bronchiolitis) is a placebo-controlled, multicenter clinical trial that aims to evaluate the efficacy of active HEPA filtration units, as compared with inactive HEPA filtration units, for reducing respiratory symptoms and increasing symptom-free days in children <12 months of age hospitalized with bronchiolitis. In 2019 the YK Health Corporation (YKHC) conducted a pilot project to provide education, HEPA filtration units and Healthy Homes Toolkits to households of children with chronic lung conditions such as bronchiectasis in the rural Yukon Kuskokwim Delta region of Alaska. In this diversity supplement, we will leverage and expand on a longstanding partnership between the Alaska ISPCTN investigators and YKHC to conduct an analysis of data from this 2019 pilot. We will assess the associations between household characteristics and HEPA filtration use, including duration of use. We will also compare household characteristics of homes with and without tobacco smokers. The proposed diversity supplement project will use existing data to support and expand the IAQ bronchiolitis trial and the ECHO focus area of upper and lower airway disease. Alaska Native/American Indian (AN/AI) people are under-represented in the medical profession and only 0.5% of We plan to mentor Madilyn Short, an Alaska Native (Yup’ik/Inupiat), first-year medical student from the rural Yukon Kuskokwim (YK) Delta region of Alaska, in a collaborative study between the Alaska ISPCTN and the Yukon Kuskokwim Health Corporation (YKHC). Madilyn is currently working as a research intern/assistant with Dr. Singleton and the Alaska Native Tribal Health Consortium’s Research Services and plans to complete her medical training and eventually practice medicine in Alaska with Alaska Native people.

项目总结/摘要 阿拉斯加原住民和美洲印第安人（ANAI）的儿童经历了严重的急性和 慢性呼吸道疾病使用木柴炉，通风不良，室内有烟草烟雾 暴露都被证明会导致室内空气质量差（IAQ），这与 儿童呼吸道感染的严重程度和频率增加。便携式HEPA净化器 已被证明可有效减少烟草和非烟草中的颗粒物 吸烟;然而，尽管已证明早期严重呼吸道感染， 儿童哮喘和成人肺部结局，没有改善IAQ的随机试验， 已对毛细支气管炎儿童的相关健康结果进行了研究。这个想法 美国儿科临床试验网络（ISPCTN）正在制定一项临床试验方案， 弥补这一差距。该提案，“减少室内空气污染的高效微粒 空气（HEPA）过滤，以减少住院后的呼吸道症状负担 细支气管炎（IAQ细支气管炎）是一项安慰剂对照的多中心临床试验，旨在 评估活性HEPA过滤装置的效率，与非活性HEPA过滤装置相比 单位，用于减少12岁以下儿童的呼吸道症状和增加无哮喘天数 月龄因细支气管炎住院。 2019年，YK健康公司（YKHC）开展了一个试点项目，提供教育， 为慢性肺病儿童家庭提供HEPA过滤装置和健康家庭工具包 在阿拉斯加的农村育空地区Kuskokwim三角洲地区，在这 多样性补充，我们将利用和扩大之间的长期伙伴关系， 阿拉斯加ISPCTN调查人员和YKHC将对2019年试点的数据进行分析。我们 将评估家庭特征与HEPA过滤使用之间的关联， 包括使用期限。此外，我们亦会比较两个家庭的住户特征， 没有吸烟者。拟议的多样性补充项目将利用现有数据， 支持和扩大IAQ细支气管炎试验和ECHO重点领域的上，下 呼吸道疾病 阿拉斯加原住民/美洲印第安人（AN/AI）在医学界的代表性不足 只有0.5%的人计划指导Madilyn Short，阿拉斯加原住民（Yup'ik/Inupiat），第一年 来自阿拉斯加州农村育空地区Kuskokwim（YK）三角洲地区的医学生，在一个合作项目中 阿拉斯加ISPCTN和育空地区Kuskokwim卫生公司（YKHC）之间的研究。 Madilyn目前在Singleton博士和阿拉斯加大学担任研究实习生/助理。 土著部落健康联盟的研究服务，并计划完成她的医疗 在阿拉斯加与阿拉斯加原住民一起培训并最终行医。