Contextualizing Asthma Self-Management with Measures of Indoor Air Quality for Black Adults with Uncontrolled Asthma

将哮喘自我管理与哮喘不受控制的黑人成人的室内空气质量测量结合起来

• 批准号: 10671775
• 负责人: MAUREEN GEORGE
• 金额: $ 12.07万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-23 至 2026-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10671775
• 关键词: Address; Adult; Adverse effects; Affect; Air; Air Pollutants; Asthma; Attitude; Black race; Caring; Centers for Population Health; Childhood; Chronic; Client; Collaborations; Communities; Community Health; Data; Data Collection; Disease; Electricity; Eligibility Determination; Enrollment; Evaluation; Federally Qualified Health Center; Gases; Global Warming; Goals; Greenhouse Effect; Health; Health Promotion; Hispanic; Home; Housing; Human; Individual; Indoor Air Quality; Intervention; Interview; Lead; Low income; Measures; Methane; Methods; Natural Gas; New York; New York City; Nitrogen; Nitrogen Dioxide; Not Hispanic or Latino; Outcome; Ozone; PMP22 gene; Parents; Participant; Particulate Matter; Patients; Persons; Phase; Population; Poverty; Prevalence; Prevention; Procedures; Process; Propane; Race; Research; Research Support; Respiratory Disease; Retrieval; Role; Sampling; Self Management; Source; Strategic Planning; Structure; Time; Training; Vent; ambient air pollution; climate change; climate-related health; cohort; design; disorder control; experience; greenhouse gases; health equity; health inequalities; high risk; improved; indoor pollutant; negative affect; pollutant; population health; primary care setting; recruit; remediation; respiratory; respiratory health; satisfaction; social health determinants; ventilation

Background and Rationale: The air we breathe affects our health. Because people spend as much as 90% of their time indoors, indoor air quality (IAQ) is particularly important to health. Climate change has worsened IAQ most prominently, via increasing greenhouse gases (GHGs). Methane, a potent GHG, is the primary component of natural gas and gas appliances are the main residential source of methane. More than 40% of all homes use natural gas as their stove’s fuel source and use in New York City is much higher, especially in low- income housing, since gas appliances are cheaper and most renters pay for electricity but not for gas. The combustion of natural gas generates indoor pollutants. Increasing evidence finds that even low levels of these pollutants are hazardous for human health. Those most vulnerable to ambient air pollution live in homes with gas appliances and inadequate ventilation and those with pre-existing diseases like asthma are particularly susceptible to adverse health effects from IAQ, which gas stoves may exacerbate. While the association between IAQ and negative affects on pediatric respiratory health have been established, less is known about its effect on adult respiratory health. Black adults with uncontrolled asthma are both vulnerable and susceptible to poor IAQ but the impact of gas stoves in open kitchens in apartments in which Black adults with uncontrolled asthma reside has not been the focus of prior research. Objective: The aims of this project are twofold: 1) to characterize IAQ components obtained from apartments with gas stoves and open kitchens in a cohort of Black adults with uncontrolled asthma recruited from federally qualified health centers and enrolled in the parent R01 and 2) to conduct a comprehensive assessment of feasibility including process (i.e., recruitment & eligibility), implementation (i.e., data collection completion, retention, fidelity to IAQ sampling procedures) and acceptability (i.e., satisfaction) metrics. Together, these findings will provide the groundwork for a later study showing health effects of IAQ and targets for individual or community level interventions to mitigate exposure. Methods: The proposed study includes two phases: (1) two-week IAQ sampling from a subset (n=30) of the 200 participants enrolled in the parent R01 and (2) a feasibility evaluation which includes process, implementation and acceptability metrics. Semi-structured interviews at the time of IAQ sample retrieval will be guided by the constructs of the Theoretical Framework of Acceptability (e.g., burden, user experience, attitudes, participation intentions). Significance: The interdisciplinarity of climate change research necessitates new kinds of research collaborations to address newly emerging problems. The data gained from real-world settings among communities experiencing profound health inequities could lead to important findings that directly relates to the parent R01s goal of improving disease control in Black adults with uncontrolled asthma, addressing four pillars of NINRs new strategic plan: health equity, social determinants of health, population and community health, and prevention and health promotion.

背景和理由：我们呼吸的空气会影响我们的健康。因为人们花费多达90％ 他们的时间在室内，室内空气质量（IAQ）对健康尤为重要。气候变化已经忘记了IAQ 最突出的是，通过增加温室气体（GHG）。甲烷，一种潜在的温室气体，是主要的 天然气和气体电器的成分是甲烷的主要居住源。超过40％ 房屋使用天然气作为炉灶的燃料来源，在纽约市使用的燃料来源要高得多，尤其是在低 - 收入住房，因为天然气设备便宜，大多数租金就为电费支付，但不支付汽油。 天然气的燃烧会产生室内污染物。越来越多的证据发现甚至低水平 污染物对人类健康有害。那些最容易受到环境空气污染的人生活在与 气体用具和通风不足，患有哮喘等先前疾病的电器尤其是 容易受到IAQ的不良健康影响，燃气炉可能会加剧。同时协会 在IAQ和对小儿呼吸健康健康的负面影响之间，对 它对成人呼吸健康的影响。哮喘不受控制的黑人成年人既脆弱又易感 对于不良的IAQ，但燃气炉的影响在公寓的开放式厨房中，黑人成年人不受控制 哮喘居住并不是先前研究的重点。目的：该项目的目的是双重的：1） 表征从带有燃气炉和开放式厨房的公寓获得的IAQ组件 从联邦合格的卫生中心招募的黑人成年人患有不受控制的哮喘，并参加了 家长R01和2）对可行性进行全面评估，包括流程（即招聘和 资格），实施（即数据收集完成，保留，对IAQ采样程序的保真度）和 可接受性（即满意度）指标。这些发现将共同为以后的研究提供基础 显示了IAQ和目标对个体或社区水平干预措施的健康影响，以减轻暴露量。 方法：拟议的研究包括两个阶段：（1）从该子集（n = 30）的两周IAQ采样（n = 30） 200名参与者参加了家长R01和（2）包括流程的可行性评估， 实施和可接受的指标。 IAQ样本检索时的半结构化访谈将是 以可接受性理论框架的构建为指导（例如，伯恩，用户体验， 态度，参与意图）。意义：气候变化研究的跨学科性 需要新的研究合作来解决新出现的问题。从中获得的数据 经历严重健康不平等的社区之间的现实环境可能会导致重要 与父母R01的目标直接相关的发现，即改善黑人成年人的疾病控制 未受控制的哮喘，针对NINRS的四个支柱新战略计划：健康平等，社会决定者 健康，人口和社区健康以及预防和健康促进。