Contextualizing Asthma Self-Management with Measures of Indoor Air Quality for Black Adults with Uncontrolled Asthma

背景和原理：我们呼吸的空气影响我们的健康。因为人们花费高达90%的 在室内，室内空气质量（IAQ）对健康尤为重要。气候变化导致IAQ恶化 最主要的是，通过增加温室气体（GHG）。甲烷是一种潜在的温室气体， 天然气和燃气用具的组成部分是甲烷的主要住宅来源。超过40%的 家庭使用天然气作为炉子燃料来源，纽约市的使用率要高得多，特别是在低能耗地区， 由于燃气器具更便宜，而且大多数租房者支付电费，但不支付燃气费，的 天然气的燃烧产生室内污染物。越来越多的证据表明，即使是低水平的 污染物对人体健康有害。那些最容易受到环境空气污染影响的人居住在 煤气用具和通风不足，以及那些患有哮喘等疾病的人， 容易受到室内空气质量的不利健康影响，而燃气灶可能会加剧这种影响。虽然协会 室内空气质量和对儿童呼吸健康的负面影响之间的关系已经建立，但对 对成人呼吸系统健康的影响。患有不受控制的哮喘的黑人成年人既脆弱又易感 但在公寓的开放式厨房煤气炉的影响，其中黑人成年人与不受控制的 哮喘的发病机制尚未成为以往研究的重点。目的：本项目的目的有两个：1） 表征IAQ组件获得的公寓与燃气灶和开放式厨房在一个队列的 患有不受控制的哮喘的黑人成年人从联邦合格的健康中心招募， 母公司R01和2）进行全面的可行性评估，包括工艺（即，招聘& 资格）、实施（即，数据收集完成、保存、忠实于室内空气质量采样程序）， 可接受性（即，满意度）度量。总之，这些发现将为以后的研究提供基础 显示室内空气质量对健康的影响，以及个人或社区层面干预措施的目标，以减轻暴露。 方法：本研究包括两个阶段：（1）从一个子集（n=30）中抽取两周的室内空气质量样本， 200名参与者入组母公司R01，以及（2）可行性评价，包括过程， 实施和可接受性指标。在室内空气质量样本检索时， 在可接受性理论框架（例如，负担，用户体验， 态度、参与意向）。意义：气候变化研究的跨学科性 需要新型的研究合作来解决新出现的问题。数据来自 在经历严重卫生不平等的社区中，现实世界的环境可能导致重要的 研究结果直接关系到父母R01的目标，即改善黑人成年人的疾病控制， 不受控制的哮喘，解决NINR新战略计划的四大支柱：健康公平， 卫生、人口和社区卫生以及预防和促进健康。

Background and Rationale: The air we breathe affects our health. Because people spend as much as 90% of their time indoors, indoor air quality (IAQ) is particularly important to health. Climate change has worsened IAQ most prominently, via increasing greenhouse gases (GHGs). Methane, a potent GHG, is the primary component of natural gas and gas appliances are the main residential source of methane. More than 40% of all homes use natural gas as their stove’s fuel source and use in New York City is much higher, especially in low- income housing, since gas appliances are cheaper and most renters pay for electricity but not for gas. The combustion of natural gas generates indoor pollutants. Increasing evidence finds that even low levels of these pollutants are hazardous for human health. Those most vulnerable to ambient air pollution live in homes with gas appliances and inadequate ventilation and those with pre-existing diseases like asthma are particularly susceptible to adverse health effects from IAQ, which gas stoves may exacerbate. While the association between IAQ and negative affects on pediatric respiratory health have been established, less is known about its effect on adult respiratory health. Black adults with uncontrolled asthma are both vulnerable and susceptible to poor IAQ but the impact of gas stoves in open kitchens in apartments in which Black adults with uncontrolled asthma reside has not been the focus of prior research. Objective: The aims of this project are twofold: 1) to characterize IAQ components obtained from apartments with gas stoves and open kitchens in a cohort of Black adults with uncontrolled asthma recruited from federally qualified health centers and enrolled in the parent R01 and 2) to conduct a comprehensive assessment of feasibility including process (i.e., recruitment & eligibility), implementation (i.e., data collection completion, retention, fidelity to IAQ sampling procedures) and acceptability (i.e., satisfaction) metrics. Together, these findings will provide the groundwork for a later study showing health effects of IAQ and targets for individual or community level interventions to mitigate exposure. Methods: The proposed study includes two phases: (1) two-week IAQ sampling from a subset (n=30) of the 200 participants enrolled in the parent R01 and (2) a feasibility evaluation which includes process, implementation and acceptability metrics. Semi-structured interviews at the time of IAQ sample retrieval will be guided by the constructs of the Theoretical Framework of Acceptability (e.g., burden, user experience, attitudes, participation intentions). Significance: The interdisciplinarity of climate change research necessitates new kinds of research collaborations to address newly emerging problems. The data gained from real-world settings among communities experiencing profound health inequities could lead to important findings that directly relates to the parent R01s goal of improving disease control in Black adults with uncontrolled asthma, addressing four pillars of NINRs new strategic plan: health equity, social determinants of health, population and community health, and prevention and health promotion.