AIM to Improve Asthma: Airflow Improvements during Meal-prep

旨在改善哮喘：膳食准备期间的气流改善

• 批准号: 9896653
• 负责人: John R Balmes
• 金额: $ 30.55万
• 依托单位: UNIVERSITY OF CALIFORNIA BERKELEY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-03-18 至 2022-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9896653
• 关键词: Advocacy; Affect; Age; Air Movements; Air Pollutants; Asthma; Awareness; Building Codes; California; Chemicals; Child; Childhood; Childhood Asthma; Chronic Disease; Cities; Communities; Control Groups; Data; Data Collection; Developed Countries; Education; Educational Materials; Educational process of instructing; Environmental Health; Event; Exhalation; Family; Gases; Goals; Health Promotion; Health education; Home environment; Hour; Household; Household Air Pollution; Indoor Air Pollution; Intervention; Interview; Lead; Leadership; Low income; Lung diseases; Manufacturer Name; Measurement; Measures; Modeling; Nitric Oxide; Nitrogen Dioxide; Noise; Participant; Particulate Matter; Pattern; Physicians; Prevalence; Quality of life; Questionnaires; Randomized; Randomized Controlled Trials; Recommendation; Reporting; Research; Research Design; Research Methodology; Research Project Grants; Resources; Respiratory Signs and Symptoms; Respiratory physiology; Role; Salinas Valley; Sample Size; Sampling; Schools; Source; Spirometry; Symptoms; Testing; Training; United States; Visit; Youth; airway inflammation; asthma exacerbation; community based participatory research; cooking; cost; design; exhaust; fine particles; foot; improved; indoor particulate matter; indoor pollutant; member; pollutant; public health priorities; randomized trial; recruit; sensor; skills; ventilation; volatile organic compound

Asthma is one of the most prevalent chronic diseases of childhood. Because children spend many hours indoors at home, interventions to decrease asthma-exacerbating exposures in the home could have profound impacts. In addition, many pollutants, such as fine particulate matter (PM2.5) and Nitrogen dioxide (NO2) have higher levels indoors than outdoors, even in the developed world. Air pollutants may worsen asthma symptoms through multiple mechanisms, including by directly increasing airways inflammation. One of the primary sources of indoor pollutants in the United States is cooking with gas stoves, and cooking-related pollutants have been shown to be related to increases in asthma symptoms. In a nationally representative sample, children who live in homes where cooking ventilation is not used have higher rates of asthma and other respiratory diseases. This study will be a pilot stepped-wedge randomized trial in homes with both a child with asthma and a gas stove, assessing an intensive cooking ventilation intervention. The long-term goal is to provide the scientific rationale for an easily implementable household air pollution intervention. The primary aim of this project will be to assess the effect of the cooking ventilation intervention on household PM2.5 and NO2 levels, and a secondary aim is to assess the effect of the cooking ventilation on short-term measures of pediatric asthma control, as improvements could result either from changes in PM2.5 and NO2 or from changes in other chemicals. As a youth participatory action research project, a third aim will be to develop scientific leadership capacity in community youth. This will be the first trial to both replace stove hoods for improved cooking ventilation in the homes of children with asthma and objectively measure both stove and hood fan use. Moreover, the stepped wedge design will allow for analysis in two ways: first as a randomized controlled trial (to minimize confounding) and secondly as a before-after trial (to maximize sample size). All homes will receive measurement of air flow through the range hood, and an intervention with two parts: (1) replacement of the range hood if air flow is less than the California building code level of 100 cubic feet per minute (cfm) or intolerably noisy and (2) intensive education regarding the use of the range hood during all cooking events and cleaning of the grease screen. A manufacturer (Broan), which has no role in the design of the study, plans to provide replacement hoods if the airflow is inadequate. Stove and Range hood sensors will also be installed in participant homes for the entire 3-week data collection period, with study visits at initiation and every week thereafter, for a total of four visits spanning three weeks of data collection. Those randomized to group 1 (30 homes) will receive the intervention after one week of baseline data collection and group 2 (30 homes) will receive it after two weeks. Measured variables will include stove use, range hood use, PM2.5 and NO2 in the household, and multiple measures of asthma control in the children (spirometry, Fractional exhaled Nitric Oxide, asthma control questionnaire, ISAAC Asthma and Environmental Questionnaires).

哮喘是儿童最常见的慢性疾病之一。因为孩子们花很多时间 在室内，干预措施，以减少哮喘加剧暴露在家里可能有深远的影响， 影响。此外，许多污染物，如细颗粒物（PM2.5）和二氧化氮（NO2）， 室内比室外高，即使在发达国家。空气污染物可能加重哮喘 症状通过多种机制，包括直接增加气道炎症。之一 在美国，室内污染物的主要来源是用煤气炉做饭， 污染物已被证明与哮喘症状的增加有关。在具有全国代表性的 样本中，生活在不使用烹饪通风设备的家庭中的儿童患哮喘的几率较高， 其他呼吸道疾病。这项研究将是一个试点的阶梯楔形随机试验，在家庭中， 哮喘和煤气炉，评估强化烹饪通风干预。长期目标是 为易于实施的家庭空气污染干预提供科学依据。主 该项目的目的是评估烹饪通风干预对家庭PM2.5的影响， NO2水平，次要目的是评估烹饪通风对短期措施的影响， 儿童哮喘控制，因为改善可能是由于PM2.5和NO2的变化， 其他化学品。作为一个青年参与性行动研究项目，第三个目标将是发展科学的 社区青年的领导能力。这将是第一次试验，以取代炉灶罩， 哮喘儿童家中的烹饪通风，并客观地测量炉灶和油烟机的使用情况。 此外，阶梯式楔形设计将允许以两种方式进行分析：首先作为随机对照试验 (to最大限度地减少混杂），其次是作为前后试验（以最大限度地增加样本量）。所有家庭将 接收测量通过抽油烟机的空气流量，并用两部分进行干预：（1）更换 抽油烟机，如果空气流量低于加州建筑规范规定的每分钟100立方英尺（cfm），或 难以忍受的噪音和（2）关于在所有烹饪活动中使用抽油烟机的强化教育， 清洗油脂滤网。制造商（Broan）在研究设计中没有任何作用，计划 如果气流不足，则提供更换的通风罩。炉灶和抽油烟机传感器也将安装在 在整个3周的数据收集期内，受试者在家，在开始时和每周进行研究访视 此后，在为期三周的数据收集期间，共进行了四次访问。随机分配至第1组（30例 第二组（30个家庭）将在基线数据收集一周后接受干预， 两周后收到。测量的变量将包括炉灶的使用、抽油烟机的使用、空气中的PM2.5和NO2 家庭，以及儿童哮喘控制的多种措施（肺功能测定，呼出气硝酸盐分数， 哮喘控制问卷，ISAAC哮喘和环境问卷）。