Asthma Intervention in New York City: A Community Based Participatory Research Project

Patrick L. Kinney, Sc.D.
Columbia University
R21ES09142 and P30ES09089

Background: The Community Based Participatory Research Program was started by NIEHS in 1995. The purpose of awards in this program is to develop community-based public health research approaches to diseases and health conditions having an environmentally related etiology and determine the impact of these methods. Awards are intended to stimulate further advances in the design and implementation of prevention and intervention methods that are appropriately applied to environmental health; accumulate and evaluate data, making assignments of environmental etiologies of diseases more plausible; and develop, implement, and evaluate community-based exposure assessment protocols.

One grant in this program was awarded to researchers at Columbia University in northern Manhattan to study the effects of allergens and air pollutants on asthma incidence in inner-city children. The main effort of this grant is to determine whether a comprehensive integrated pest management intervention, including use of pesticides, repairing cracks and leaks, and educating participants in maintaining pest-free environments, will reduce the severity of asthma symptoms and improve the clinical management of asthma in the study participating children. In designing and initiating the study, the researchers have learned several important lessons that may help similar research projects carry on more smoothly.

Advance: Participant recruitment through informal community contacts proved to be insufficient. The researchers turned to the local medical center to find asthma patients interested in participating. This proved that multiple community organizations are necessary to enroll adequate numbers of study participants. Having good communication skills, education, and getting the participants involved have all been reinforced as essential components of a successful intervention. The researchers have also determined that poor housing quality is a severe detriment in keeping pest infestations down. Poor enforcement of standards has led to the formation of citizens groups whose goal is to lobby city officials for better enforcement of housing ordinances.

Implication: While not complete, this study highlights the challenges encountered in community-based research activities. It has shown that community involvement on many levels is essential if interventions are to succeed. This program can serve as an example of how research protocols need to be flexible and global in scope and will be beneficial for other community-based researchers in designing future experiments.

Citation: Kinney PL, Northridge ME, Chew GL, Gronning E, Joseph E, Correa JC, Prakash S, Goldstein I. On the front lines: an environmental asthma intervention in New York City. Am J Public Health. 2002 Jan;92(1):24-6.