Aggravating Factors of Asthma in a Rural Environment

农村环境中哮喘的加重因素

• 批准号: 7798377
• 负责人: MATTHEW C KEIFER
• 金额: $ 32.64万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-24 至 2013-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7798377
• 关键词: Address; Adult; Affect; Agricultural Workers; Agriculture; Agrochemicals; Animal Feed; Animals; Asthma; Breathing; Cellular Phone; Child; Clinic; Clinical; Collaborations; Communication; Communities; Community Health; Community Health Education; Computer software; Data; Data Collection; Development; Dictyoptera; Dust; Education; Educational Curriculum; Enrollment; Environment; Environmental Risk Factor; Evaluation; Exhalation; Exposure to; Family; Growth; Guidelines; Health; Health Priorities; Hispanics; Home environment; Hour; Humulus; Impact evaluation; Individual; Instruction; Irritants; Livestock; Location; Maps; Measurement; Measures; Molds; Monitor; Morbidity - disease rate; National Heart, Lung, and Blood Institute; Nature; Nitric Oxide; Observational Study; Outcome; Paper; Participant; Patient Self-Report; Patients; Peak Expiratory Flow; Pesticides; Pharmaceutical Preparations; Phase; Pollen; Procedures; Process; Production; Property; Protocols documentation; Provider; Radio; Recording of previous events; Reporting; Role; Rural; Sampling; Severities; Skin; Source; Spirometry; Students; Surveys; Symptoms; Telephone; Testing; Time; Tobacco smoke; Training; Translating; Translational Research; United States; Universities; Urban Population; Washington; Work; aged; air sampling; airborne allergen; base; chemical allergen; cohort; community organizations; experience; farm worker; innovation; meter; methacholine; outreach; outreach program; peak flow measurement; pollutant; prevent; programs; public health relevance; response; tool; toxicant; trafficking; wasting

DESCRIPTION (provided by applicant): Asthma and factors that aggravate asthma in the rural setting are key health priorities identified in an ongoing community-academic partnership, Proyecto Bienestar (PB). This longstanding partnership is a collaboration between the Northwest Community Education Center (NCEC)/KDNA Radio, the Yakima Valley Farm Workers Clinic (YVFWC), Heritage University and the University of Washington (UW). Preventing exacerbations is the most important challenge in asthma treatment and national guidelines recognize the role of indoor environmental factors and traffic-related pollutants. This project addresses an important data gap regarding the role of ambient environmental factors that affect a rural Hispanic population, where asthma morbidity is disproportionately high. In the first phase of the project we will geo- temporally locate episodes of asthma aggravation among a cohort of clinically confirmed asthmatics and utilize geographic information software to map the distribution of agricultural processes that may be responsible for triggering these episodes. The most common suspected ambient triggers will be prioritized. Guided by the timing of the suspected agricultural processes and the reported episodes, sampling with an innovative multi channel sampler will be done with a grid of community-based monitors which will sample air for the suspected aggravators. The asthmatic cohort will continue to be followed into year three. Analysis will focus on concentrations of the suspected triggers which will be compared to reports of new asthma exacerbations by subjects. An educational outreach program based on confirmed and/or strongly suspected aggravators will be developed for delivery through Radio KDNA, the YVFWC and the University of Washington. A clinician training curricula based on management of rural asthmatics will be developed and delivered to the YVFWC clinical providers and their Asthma Outreach Program community health workers. Evaluation will include process evaluation of PB, outcome evaluation of enhanced data collection and asthma management and product quantification including papers, presentations and student participants and impact evaluation of changes community response. PUBLIC HEALTH RELEVANCE: This community based project characterizes ambient triggers of asthma in the rural setting by following 50 asthmatic community subjects, geo-temporally plotting their exacerbations and comparing these with known agricultural exposures. Subsequently, ambient sampling with an innovative and adaptable sampler will confirm the nature of the exposures and an informational campaign will share the findings with the public, clinicians and the scientific community. A multifaceted evaluation will assess the process, outcomes and impact of the program on the partnership, the participants, the clinical providers and the community.

描述(由申请人提供)：哮喘和在农村环境中加重哮喘的因素是正在进行的社区-学术伙伴关系Proyecto Bienestar(PB)确定的关键卫生优先事项。这一长期的合作伙伴关系是西北社区教育中心(NCEC)/KDNA电台、亚基马山谷农场工人诊所(YVFWC)、传统大学和华盛顿大学(UW)之间的合作。防止哮喘恶化是哮喘治疗中最重要的挑战，国家指南认识到室内环境因素和与交通相关的污染物的作用。该项目解决了一个重要的数据缺口，即影响农村拉美裔人口的环境环境因素的作用，那里的哮喘发病率高得不成比例。在该项目的第一阶段，我们将在临床确诊的哮喘患者队列中定位哮喘加重的地理时间段，并利用地理信息软件绘制可能导致这些哮喘发作的农业过程的分布。最常见的可疑环境触发器将按优先顺序排列。根据可疑农业过程和报告的事件的时间安排，将使用创新的多通道采样器进行采样，并使用基于社区的监测仪网格，为可疑的加重者采样空气。哮喘队列将继续跟踪到第三年。分析将重点放在可疑诱因的浓度上，并将其与受试者新发哮喘加重的报告进行比较。将通过KDNA电台、基督教青年会和华盛顿大学开展一项以确诊和/或疑似加重者为基础的教育外展计划。将制定以农村哮喘患者管理为基础的临床医生培训课程，并向YVFWC临床提供者及其哮喘外联计划社区卫生工作者提供培训。评估将包括对PB的过程评估、加强数据收集和哮喘管理的结果评估、包括论文、演示文稿和学生参与者的产品量化，以及对变化的社区反应的影响评估。 公共卫生相关性：这个以社区为基础的项目通过跟踪50名哮喘社区受试者，在地理上绘制他们的病情加重图，并将这些与已知的农业暴露进行比较，来表征农村环境中哮喘的触发因素。随后，使用创新和可适应的采样器进行环境采样将确认暴露的性质，并将与公众、临床医生和科学界分享调查结果。一个多方面的评估将评估该计划的过程、结果和对合作伙伴、参与者、临床提供者和社区的影响。