Evaluation of a HEPA Filter Pilot Project: Formative Data to Support a Future Indoor Air Quality Bronchiolitis Clinical Trial

项目摘要/摘要 阿拉斯加原住民和美国印第安人(Anai)儿童经历了严重和 慢性呼吸道疾病。使用柴火、通风不良和室内烟草烟雾 暴露于空气中都被证明会导致室内空气质量差(IAQ)，这与 儿童呼吸道感染的严重程度和频率增加。便携式高效空气净化器 已被证明在减少烟草和非烟草的颗粒物方面是有效的 吸烟；然而，尽管证明了早期严重呼吸道感染之间的联系， 儿童哮喘和成人肺部结局，没有随机试验来改善IAQ和 对毛细支气管炎儿童的相关健康结果进行了研究。这个想法 美国儿科临床试验网络(ISPCTN)正在开发一项临床试验方案，以 弥补这一差距。《用高效颗粒物减少室内空气污染》的建议 空气(HEPA)过滤减轻住院患者呼吸道症状负担 毛细支气管炎(IAQ毛细支气管炎)是一项安慰剂对照的多中心临床试验，旨在 评价主动式高效空气过滤器与非主动式高效空气过滤器的效果 用于减少呼吸道症状和增加儿童无症状天数的单位 因毛细支气管炎住院数月。 2019年，YK Health Corporation(YKHC)开展了一项提供教育的试点项目， 为慢性肺病儿童家庭提供高效空气过滤装置和健康家庭工具包 阿拉斯加育空库什科维姆三角洲农村地区的支气管扩张症。在这 多样性补充，我们将利用和扩大两国之间的长期合作伙伴关系 阿拉斯加ISPCTN调查人员和YKHC对2019年试点的数据进行分析。我们 将评估家庭特征和高效空气过滤器使用之间的联系， 包括使用时长。我们还会将房屋的住户特征与和 没有吸烟者。拟议的多样性补充项目将利用现有数据 支持和扩大室内空气质量毛细支气管炎试验和上下回声焦点区域 呼吸道疾病。 阿拉斯加原住民/美国印第安人(AN/AI)在医疗职业中的代表性不足 只有0.5%的人计划在第一年指导阿拉斯加当地人Madilyn Short(Yup‘ik/Inupiat) 来自阿拉斯加Yukon Kuskokwim(YK)三角洲农村地区的医学生在一个合作项目中 阿拉斯加ISPCTN和Yukon Kuskokwim Health Corporation(YKHC)之间的研究。 Madilyn目前在Singleton博士和阿拉斯加大学担任研究实习生/助理 土著部落健康联盟的研究服务，并计划完成她的医疗 培训并最终在阿拉斯加与阿拉斯加原住民一起行医。

PROJECT SUMMARY/ABSTRACT Alaska Native and American Indian (ANAI) children experience a high burden of acute and chronic respiratory disease. Wood stove use, poor ventilation, and indoor tobacco smoke exposure have all been shown to cause poor indoor air quality (IAQ), which is associated with increased severity and frequency of respiratory infections in children. Portable HEPA purifiers have been shown to be effective in reducing particulate matter from tobacco and nontobacco smoke; however, despite demonstrated links between early-life severe respiratory infections, pediatric asthma, and adult pulmonary outcomes, no randomized trials to improve IAQ and associated health outcomes in children with bronchiolitis have been conducted. The IDeA States Pediatric Clinical Trials Network (ISPCTN) is developing a protocol for a clinical trial to address this gap. The proposal, “Reduction of indoor air pollution with high efficiency particulate air (HEPA) filtration to decrease respiratory symptom burden after hospitalization for bronchiolitis (IAQ bronchiolitis) is a placebo-controlled, multicenter clinical trial that aims to evaluate the efficacy of active HEPA filtration units, as compared with inactive HEPA filtration units, for reducing respiratory symptoms and increasing symptom-free days in children <12 months of age hospitalized with bronchiolitis. In 2019 the YK Health Corporation (YKHC) conducted a pilot project to provide education, HEPA filtration units and Healthy Homes Toolkits to households of children with chronic lung conditions such as bronchiectasis in the rural Yukon Kuskokwim Delta region of Alaska. In this diversity supplement, we will leverage and expand on a longstanding partnership between the Alaska ISPCTN investigators and YKHC to conduct an analysis of data from this 2019 pilot. We will assess the associations between household characteristics and HEPA filtration use, including duration of use. We will also compare household characteristics of homes with and without tobacco smokers. The proposed diversity supplement project will use existing data to support and expand the IAQ bronchiolitis trial and the ECHO focus area of upper and lower airway disease. Alaska Native/American Indian (AN/AI) people are under-represented in the medical profession and only 0.5% of We plan to mentor Madilyn Short, an Alaska Native (Yup’ik/Inupiat), first-year medical student from the rural Yukon Kuskokwim (YK) Delta region of Alaska, in a collaborative study between the Alaska ISPCTN and the Yukon Kuskokwim Health Corporation (YKHC). Madilyn is currently working as a research intern/assistant with Dr. Singleton and the Alaska Native Tribal Health Consortium’s Research Services and plans to complete her medical training and eventually practice medicine in Alaska with Alaska Native people.