Action towards health equity and improved air quality in the Duwamish Valley: A multilevel asthma intervention

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Project Summary/Abstract The Georgetown and South Park communities of the Duwamish Valley (DV) face higher levels of environmental pollution and poorer health outcomes compared to the rest of Seattle. For many years the communities have organized to address these environmental and health disparities, prioritizing air pollution and asthma. Our proposal is (1) directly responsive to community requests, (2) strengthens previous community-academic-government partnerships in the DV, (3) advances the environmental health interests of the community, (4) investigates low-cost tools for the measurement and control of air pollution, and (5) evaluates individual and community empowerment throughout all phases of research and action. This multilevel community engaged research (CEnR) project proposes elements that will engage and empower members of the DV community. The household-level intervention - providing participants with indoor air filters - has the goal of improving indoor air quality and reducing asthma symptoms in children. In contrast with previous studies investigating high-efficiency particulate air (HEPA) filtration, our intervention will evaluate the effectiveness of low-cost box fans equipped with lower-efficiency filters with greater airflow. The low-cost filters will be coupled with established home-based multicomponent, multi-trigger indoor air quality assessment of homes. We will conduct a randomized control trial to rigorously evaluate differences between intervention and control households in asthma outcomes such as symptoms and forced expiratory volume and in concentrations of indoor particulate matter (PM) and black carbon (BC). Promotores and healthy home consultants recruited from the community will be instrumental in carrying out the intervention. At the community level, we will expand community-driven ambient air monitoring campaigns, prioritizing the characterization of traffic-related air pollution, identification of pollutant sources, and emissions reductions. The use of a low-cost monitoring network will improve the spatial resolution of air quality data in the DV, enabling us to identify PM, BC and nitrogen dioxide hotspots. Youth from the well-established Duwamish Valley Youth Corp program will be trained in various aspects of air monitoring to help carry out the campaign. Armed with data on air quality, community members (who will also be trained in policy advocacy) can advocate for structural change including policy, infrastructure improvements such as urban green space, and targeted regulation of industrial and/or transportation emissions. Throughout the project, independent evaluation of individual and community engagement and empowerment will be tracked. From defining scientific goals, to project implementation and evaluation, our CEnR approach is designed to engage and empower a resilient community in its goal to advance health equity.