Peer Education in Pregnancy Study

描述（由申请人提供）： 该项目的目的是扩大调查人员以前资助的 怀孕研究中的同伴教育。 研究的总体目标是 检查旨在改变家庭的同伴教育的效果 环境对儿童哮喘发病的影响。 第二个目标是检查环境，社会心理和 在整个队列中，营养风险因素对哮喘发生的影响。 这项建议的具体目标是将征聘总数增加到500人 孕妇及其未出生的婴儿;增加对 儿童3-5岁;扩大暴露评估，包括粉尘 内毒素、拟除虫菊酯、有机磷和尿液的测量 农药代谢物的测量;扩大社会心理和营养 评估包括家庭功能、压力和饮食的测量， 1-5岁;扩大免疫评估，包括测量 白细胞介素（IL-4、IL-13和干扰素-γ）。 的 同伴教育对3-5岁哮喘发展的影响，以及 同伴教育对中间终点的影响，如吸烟， 暴露于室内过敏原（猫、蟑螂、螨、小鼠、β-葡聚糖和 内毒素），接触杀虫剂（拟除虫菊酯和有机磷酸盐），以及 免疫功能（IgE水平，过敏原和细胞因子的皮肤测试）将 接受检查。 被动吸烟暴露与过敏原和 农药，以及心理社会功能和营养措施， 整个队列中哮喘和呼吸道症状的发展将 也可以探索。 这项研究的结果将有助于阐明 哮喘在生命早期发展的病因学途径，以及协助 制定有效的干预方案。

DESCRIPTION (provided by applicant): The purpose of this project is to extend the investigators' previously funded Peer Education in Pregnancy Study. The overall goal of the study is to examine the effect of peer education aimed at modification of the home environment on the development of asthma in children at risk for the disease. Secondary goals are to examine the effect of environmental, psychosocial, and nutritional risk factors on the development of asthma in the overall cohort. Specific aims of this proposal are to increase the total recruitment to 500 pregnant women and their unborn infants; increase the time of follow-up of the children to age 3-5 years; expand the exposure assessment to include dust measurements of endotoxins, pyrethroids, and organophosphates and urine measurements of pesticide metabolites; extend the psychosocial and nutritional assessments to include measurements of family function stress and diet during years 1-5; and expand immune assessments to include measurements of interleukins (IL-4, IL-13, and interferon-gamma) at one year of age. The effect of peer education on the development of asthma by age 3-5, as well as the effect of peer education on intermediary endpoints such as smoking, exposure to indoor allergens (cat, cockroach, mite, mouse, beta-glucan, and endotoxins), exposure to pesticides (pyrethroids and organophosphates), and immune function (IgE levels, skin testing for allergens, and cytokines) will be examined. Relationships of exposure to passive smoke, allergens, and pesticides, as well as measures of psychosocial function and nutrition, with the development of asthma and respiratory symptoms in the overall cohort will also be explored. Results of this study will assist in elucidating the etiologic pathway by which asthma develops early in life, as well as assist in the development of effective intervention programs.