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

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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.