PARTICULATE REDUCTION EDUCATION IN CITY HOMES (PREACH)

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 在对哮喘患者的研究中，环境空气中的颗粒物(PM)与呼吸道发病率有关(Romieu 1995)。在许多城市家庭中，颗粒物(PM)的主要可改变来源是环境烟草烟雾(ETS)。在我们之前的研究中，60%的家庭报告至少有一个吸烟者，一些家庭有多个吸烟者。在这项研究中，单个空气净化器能够将室内PM浓度降低43%，将系统性儿童的比例降低35%。(Eggleston 2005)。我们假设，空气净化器与减少的ETS相结合将导致家庭中PM10水平的降低，从而减少持续性哮喘儿童的症状天数。 我们计划招募150名6-12岁的哮喘儿童，他们居住在巴尔的摩，家中有吸烟者。所有儿童将被随机分为三组：HEPA空气净化器加ETS/室内颗粒物行为管理，HEPA空气净化器和标准哮喘教育组，以及延迟使用HEPA过滤器的标准哮喘教育组。HEPA空气净化器和减少ETS培训小组将接受两台HEPA空气净化器和一名健康教练的四次家访，以帮助家长减少子女接触ETS。HEPA空气净化器和标准哮喘教育中心的家庭将接受两台HEPA空气净化器和三次家访，以进行标准的哮喘教育。将对空气净化器的使用进行电子监测，以确定家庭使用的空气净化量。所有儿童将在基线和6个月干预结束时接受家庭检查、PM暴露监测、家庭粉尘变应原收集。在基线情况下，儿童将提供皮肤测试、尿可替宁、肺活量测定、血液嗜酸性粒细胞计数和呼出无测试。每个孩子的照顾者将在基线和6个月的随访中就家庭中的ETS减少行为、症状频率、哮喘控制、其他环境暴露和医疗保健利用结果进行访谈。这项研究的主要结果是在6个月的随访中PM10和PM2.5减少。次要结果包括减少ETS行为改变(即吸烟者在家外吸烟、儿童不与吸烟者坐在一起、家庭吸烟者数量减少)、无症状天数和卫生保健利用措施。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. In studies of persons with asthma, particulate matter (PM) in ambient air has been associated with respiratory morbidity (Romieu 1995). In many urban households, the leading modifiable source of particulate matter (PM) is environmental tobacco smoke (ETS). In our previous study 60% of households reported at least one smoker and some households with multiple smokers. In this study a single air cleaner was able to reduce indoor PM concentrations by 43% and the proportion of systematic children by 35%. (Eggleston 2005). We hypothesize that air cleaners in combination with reduced ETS will result in decreased PM10 levels in the home and subsequently reduce symptom days in children with persistent asthma. We plan to recruit 150 asthmatic children aged 6-12 years who reside in Baltimore and have a smoker in the household. All children will be randomized into three groups: HEPA air cleaners plus ETS/Indoor particulate behavior management, HEPA air cleaners and a standard asthma education and a standard asthma education group with delayed HEPA filter use. The HEPA air cleaners and ETS reduction Training Group will receive two HEPA air cleaners and four home visits by a health coach to assist the parent in reducing their child's exposure to ETS. Families in the HEPA air cleaners and Standard Asthma Education will receive two HEPA air cleaners and three home visits for standard asthma education. Use of air cleaners will be electronically monitored to determine level or "dose" of air cleaning used by families. All children will receive a home inspection, PM exposure monitoring, home dust allergen collection at baseline and at the end of the 6 month intervention. At baseline children will provide skin testing, urine cotinine, spirometry, blood for eosinophil counts and exhaled NO testing. Caregivers of each child will be interviewed at baseline and at 6 month follow-up regarding ETS reduction behaviors in the home, symptom frequency, asthma control, other environmental exposures and health care utilization outcomes. The primary outcome for this study is reduction in PM 10 and PM 2.5 over the 6 month follow-up. Secondary outcomes includes ETS reduction behavior change (i.e. smoker is smoking outside of home, child not sitting with smoker, reduction in number of household smokers), symptom free days and health care utilization measures.