Peer Education in Pregnancy Study

描述(由申请人提供)： 这个项目的目的是延长调查人员以前获得的资金 孕期同伴教育研究。这项研究的总体目标是 检查针对家庭改造的同伴教育的效果 环境对哮喘高危儿童发展的影响。 次要目标是检查环境、心理社会和 在总体队列中，营养危险因素与哮喘的发生有关。 这项提议的具体目标是将总招聘人数增加到500人 孕妇及其未出生的婴儿；增加随访的时间 3-5岁的儿童；扩大暴露评估范围，将粉尘包括在内 内毒素、拟除虫菊酯、有机磷和尿液的检测 农药代谢物的测量；扩展心理社会和营养 评估包括对家庭功能、压力和饮食的测量 1-5岁；并扩大免疫评估，以包括测量 白介素类(IL-4、IL-13和干扰素-γ)在一岁时。这个 同伴教育对3-5岁儿童哮喘发病的影响 同伴教育对吸烟等中介终点的影响， 暴露于室内过敏原(猫、蟑螂、螨虫、老鼠、β-葡聚糖和 内毒素)，接触杀虫剂(拟除虫菊酯和有机磷)，以及 免疫功能(IgE水平、皮肤过敏原检测和细胞因子)将 接受检查。暴露于被动烟雾、过敏原和 杀虫剂，以及心理社会功能和营养的措施， 哮喘和呼吸道症状在整个队列中的发展将 也是被探索的。这项研究的结果将有助于阐明 哮喘早期发展的病因学途径，以及协助 制定有效的干预方案。

DESCRIPTION (provided by applicant): The purpose of this project is to extend the investigators' previously funded Peer Education in Pregnancy Study. The overall goal of the study is to examine the effect of peer education aimed at modification of the home environment on the development of asthma in children at risk for the disease. Secondary goals are to examine the effect of environmental, psychosocial, and nutritional risk factors on the development of asthma in the overall cohort. Specific aims of this proposal are to increase the total recruitment to 500 pregnant women and their unborn infants; increase the time of follow-up of the children to age 3-5 years; expand the exposure assessment to include dust measurements of endotoxins, pyrethroids, and organophosphates and urine measurements of pesticide metabolites; extend the psychosocial and nutritional assessments to include measurements of family function stress and diet during years 1-5; and expand immune assessments to include measurements of interleukins (IL-4, IL-13, and interferon-gamma) at one year of age. The effect of peer education on the development of asthma by age 3-5, as well as the effect of peer education on intermediary endpoints such as smoking, exposure to indoor allergens (cat, cockroach, mite, mouse, beta-glucan, and endotoxins), exposure to pesticides (pyrethroids and organophosphates), and immune function (IgE levels, skin testing for allergens, and cytokines) will be examined. Relationships of exposure to passive smoke, allergens, and pesticides, as well as measures of psychosocial function and nutrition, with the development of asthma and respiratory symptoms in the overall cohort will also be explored. Results of this study will assist in elucidating the etiologic pathway by which asthma develops early in life, as well as assist in the development of effective intervention programs.