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2000 Progress Report: A Randomized, Controlled Trial of Home Exposure Control in Asthma

EPA Grant Number: R826724C001
Subproject: this is subproject number 001 , established and managed by the Center Director under grant R826724
(EPA does not fund or establish subprojects; EPA awards and manages the overall grant for this center).

Center: CECEHDPR - Johns Hopkins University Hospital
Center Director: Eggleston, Peyton A.
Title: A Randomized, Controlled Trial of Home Exposure Control in Asthma
Investigators: Eggleston, Peyton A.
Institution: Johns Hopkins University
EPA Project Officer: Fields, Nigel
Project Period: January 1, 1998 through January 1, 2002
Project Period Covered by this Report: January 1, 1999 through January 1, 2000
Project Amount: Refer to main center abstract for funding details.
RFA: Centers for Children's Environmental Health and Disease Prevention Research (1998)
Research Category: Health Effects , Children's Health

Description:

Objective:

This community-based prevention research project will conduct a randomized controlled trial of the effectiveness of current intervention methods to reduce hazardous exposure and their adverse health effects. It will test a global intervention that is composed of several components that have already proven to be effective in middle class homes. The major outcome this trial will not be changes in health status but will be environmental exposure and it will examine the feasibility of modifying inner city home environments with currently recommends procedures. Data on the child's health status will also be collected, but it is anticipated that studies with interventions that have already been proven effective will be necessary to provide adequate power to test a health outcome.

Progress Summary:

During the past year, the investigators have established recruiting, evaluation and intervention procedures. Recruiting has begun with presentation of an asthma self-management curriculum to 61 children in 49 families by two newly recruited educators. The families were visited a second time and 35 had an eligible child and interested in participating in the intervention project. Twenty-four (24) of these families have been consented and 19 have been fully evaluated and randomized into the trial. This is an extraordinarily high rate of successful recruiting and is a tribute not only to the educators but to newly recruited study interviewer and the study coordinator. During the coming year recruitment should be even more rapid as we expand the asthma curriculum from 3 to 5 elementary schools. Treatment Group will receive allergen-proof mattress and pillow encasings for the child's bed, room air cleaner for the child's room, pest control services if needed, smoking cessation support and environmental avoidance education. The intervention is being conducted by a newly recruit community health educator and a nurse educator, and has been well received by 9 families. All families will receive two home visits at 6 and 12 months, a telephone interview at 3, 6, 9, and 12 months and a final clinic evaluation.

Future Activities:

This community-based prevention research project will continue to conduct a randomized controlled trial of the effectiveness of current intervention methods to reduce hazardous exposure and their adverse health effects. It will test a global intervention that is composed of several components that have already proven to be effective in middle class homes. This study will examine the feasibility of modifying inner city home environments with currently recommended procedures. Data on the child's health status will also be collected, but it is anticipated that studies with interventions that have already been proven effective will be necessary to provide adequate power to test a health outcome. In addition, the project will establishe recruiting, evaluation and intervention procedures. Recruiting has begun with presentation of an asthma self-management curriculum to 61 children in 49 families by two newly recruited educators. The families were visited a second time and 35 had an eligible child and interested in participating in the intervention project. Twenty-four (24) of these families have been consented and 19 have been fully evaluated and randomized into the trial. This is an extraordinarily high rate of successful recruiting and is a tribute not only to the educators but to newly recruited study interviewer and the study coordinator. During the coming year recruitment should be even more rapid as they expand the asthma curriculum from 3 to 5 elementary schools. Treatment Group will receive allergen-proof mattress and pillow encasings for the child's bed, room air cleaner for the child's room, pest control services if needed, smoking cessation support and environmental avoidance education. The intervention is being conducted by a newly recruit community health educator and a nurse educator, and has been well received by 9 families. All families will receive two home visits at 6 and 12 months, a telephone interview at 3, 6, 9, and 12 months and a final clinic evalu

Supplemental Keywords:

Health, RFA, Scientific Discipline, Allergens/Asthma, Atmospheric Sciences, Biochemistry, Children's Health, Disease & Cumulative Effects, Ecological Risk Assessment, Epidemiology, Health Risk Assessment, Risk Assessments, Human Health Risk Assessment, age-related differences, air pollutants, air pollution, air toxics, airborne pollutants, airborne urban contaminants, airway disease, airway inflammation, ambient particulates, asthma, asthma morbidity, asthmatic children, children, children's environmental health, community based, community-based intervention, disease, environmental health, epidemelogy, epidemeology, health effects, human exposure, human health risk, morbidity , Air, Scientific Discipline, Health, RFA, Susceptibility/Sensitive Population/Genetic Susceptibility, Biology, indoor air, Risk Assessments, genetic susceptability, Health Risk Assessment, Children's Health, particulate matter, Environmental Chemistry, Allergens/Asthma, environmental hazard exposures, allergen, health effects, indoor air quality, respiratory problems, intervention, air quality, ambient air, indoor environment, assessment of exposure, childhood respiratory disease, antigen, human health risk, epidemeology, home, sensitive populations, biological response, air pollution, airborne pollutants, airway disease, children, asthma morbidity, exposure, household, allergic response, asthma, human exposure, Human Health Risk Assessment, morbidity
Relevant Websites:

"A Randomized, Controlled Trial of Home Exposure Control in Asthma"
http://cfpub.epa.gov/ncer_abstracts/index.cfm/fuseaction/display.abstractDehtail/abstract/1081

"Mechanisms Of Particulate-Induced Allergic Asthma"
http://cfpub.epa.gov/ncer_abstracts/index.cfm/fuseaction/display.abstractDetail/abstract/1082

"Genetic Mechanisms of Susceptibility to Inhaled Pollutants"
http://cfpub.epa.gov/ncer_abstracts/index.cfm/fuseaction/display.abstractDetail/abstract/1083

Progress and Final Reports:
Original Abstract
2002 Progress Report


Main Center Abstract and Reports:
R826724    CECEHDPR - Johns Hopkins University Hospital

Subprojects under this Center: (EPA does not fund or establish subprojects; EPA awards and manages the overall grant for this center).
R826724C001 A Randomized, Controlled Trial of Home Exposure Control in Asthma
R826724C002 Mechanisms Of Particulate-Induced Allergic Asthma
R826724C003 Genetic Mechanisms of Susceptibility to Inhaled Pollutants
R826724C004 The Relationship Of Airborne Pollutants And Allergens To Asthma Morbidity

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The perspectives, information and conclusions conveyed in research project abstracts, progress reports, final reports, journal abstracts and journal publications convey the viewpoints of the principal investigator and may not represent the views and policies of ORD and EPA. Conclusions drawn by the principal investigators have not been reviewed by the Agency.


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