COLUMBIA CENTER FOR CHILDRENS ENVIRONMENTAL HEALTH

这项研究的目的是降低非洲年轻人患哮喘的风险。 住在曼哈顿北部的美国和西班牙裔儿童 干预措施，一项在社区一级，一项在家庭一级。 社区教育干预(CEI)中心及其 社区合作伙伴，由西哈莱姆环境行动公司协调 (我们行动)将与其他以社区为基础的组织合作，包括 Alianza Dominicana，在社区范围内开发、实施和评估 采取干预措施提高对环境健康危害的认识； 特别是空气污染物和过敏原，并教育社区 成员采取行动，并在整个曼哈顿北部举行活动。这个 CEI将通过书面和视听相结合的方式进行 材料，以及在北方各地举行的公开会议和活动 曼哈顿。CEI将使用来自孕产妇的数据进行评估 来自400名母亲的问卷调查 发展研究(见福特和佩雷拉项目)。使用单个组 前测-后测研究设计，我们假设从基线到 随访24个月后CEI干预将：1.1达到10% 居住在曼哈顿北部的18-35岁的WP，EM；和1.2增加 18-35岁的妇女中采取措施预防或减少 他们的家庭或社区中的环境危害。这个 家庭干预将包括室内污染和过敏原 控制童年。当400名儿童研究他们的第二个 生日当天，我们将招收总IgE最高的120名儿童(30%) 水平--任何年龄段哮喘的最佳预测指标--为期一年的试验 预防哮喘的环境战略。登记的家庭将是 随机分配到治疗或对照研究，我们将进行干预 在治疗组户中(A)清洁和密封该制剂 包括抗氧化剂维生素A、C、E和硒(Se)，以及(C) 为孩子的母亲提供书面材料和一对一 由健康教育者就以下问题的重要性和方法进行咨询 减少家中的环境烟草烟雾(ETS)。对照组 家庭将接受安慰剂干预，其中包括多项- 不含抗氧化剂的儿童维生素制剂 维生素和有关减少暴露于ETS的书面材料。基线 数据将在每个孩子两岁生日(24个月)时收集，并 随访数据将在30个月后收集(家庭过敏原水平) 和36个月(所有指标)。我们假设从基线开始 治疗组较对照组有上升趋势：血浆浓度降低2.1 儿童体内的可替宁水平；2.2家庭蟑螂水平降低 和尘螨过敏原；2.3血浆中维生素A、C和E水平较高 和儿童中的硒；2.4低水平的血清总水平，蟑螂特异性， 用于儿童的啮齿动物特异性和尘螨特异性IgE；减少2.5 儿童哮喘或过敏的临床症状或体征。

The aim of this study is to lower the risk of asthma in young African American and Hispanic children living in northern Manhattan through two interventions, one at the community level and one at the household level. For the Community Education Intervention (CEI) the Center and its community partners, coordinated by West Harlem Environmental Action, Inc (WE ACT) will join with other community based organizations, including Alianza Dominicana, to develop, implement, and evaluate a community wide intervention to increase awareness of environmental health hazards, particularly airborne pollutants and allergens, and educate community members to take action and events held throughout Northern Manhattan. The CEI will be delivered through a combination of written and audiovisual materials, and public meetings and events held throughout Northern Manhattan. The CEI will be evaluated with data from maternal questionnaires from the cohort of 400 mothers enrolled in the developmental studies (see Ford and Perera projects). Using a single group pre-test-post-test research design, we hypothesize that from baseline to follow-up 24 months later the CEI intervention will: 1.1 Reach 10% of the wp,em aged 18-35 living in Northern Manhattan; and 1.2 Increase the percentage pf wp,em aged 18-35 who take steps to prevent or reduce environmental hazards in their households or in the community. The household intervention will consist of an Indoor Pollution and Allergen Control childhood. When the cohort of 400 children research their second birthday, we will enroll the 120 children (30%) with the highest total IgE levels--the best predictor of asthma at any age--for a one year trial of environmental strategies to prevent asthma. Enrolled families will be randomly assigned to treatment or control studies, and we will intervene in treatment group households to (a) clean and seal the preparation that includes antioxidant vitamins A, C, and E and selenium (Se), and (c) provide the child's mother with written materials and one-to-one counseling by the health educator about the importance of and methods for reducing environmental tobacco smoke (ETS) in the home. Control group families will be given a placebo intervention that includes a multi- vitamin preparation for children that does not contain the anti-oxidant vitamins and written materials about reducing exposure to ETS. Baseline data will be collected at each child's second birthday (24 months) and follow up data will be collected at 30 months (household allergen levels) and 36 months (all measures). We hypothesize that from baseline to follow up the treatment group will have, relative to controls: 2.1 reduced plasma levels of cotinine in children; 2.2 reduced household levels of cockroach and dust mite allergen; 2.3 higher plasma levels of vitamins A, C, and E and Se in children; 2.4 lower sera levels of total, cockroach-specific, rodent-specific, and dust mite-specific IgE in children; 2.5 fewer clinical signs or symptoms of asthma or allergies in children.