Jump to main content.

Research Project Search
 Enter Search Term:
   
 NCER Advanced Search

2000 Progress Report: Community-Based Intervention: Reducing Risks of Asthma

EPA Grant Number: R827027C001
Subproject: this is subproject number 001 , established and managed by the Center Director under grant R827027
(EPA does not fund or establish subprojects; EPA awards and manages the overall grant for this center).
Center: CECEHDPR - Columbia University School of Public Health
Center Director: Perera, Frederica P.
Title: Community-Based Intervention: Reducing Risks of Asthma
Investigators: Perera, Frederica P.
Institution: Columbia University
EPA Project Officer: Fields, Nigel
Project Period: August 1, 1998 through July 31, 2001 (Extended to October 31, 2004)
Project Period Covered by this Report: November 1, 1999 through October 31,2000
Project Amount: Refer to main center abstract for funding details.
RFA: Centers for Children's Environmental Health and Disease Prevention Research (1998)
Research Category: Children's Health , Health Effects

Description:

Objective:

The Community-based Intervention consists of two projects, one focused on the women living in Northern Manhattan, and the other on a subset of the cohort of families enrolled in the Mothers and Newborns Study.

The specific aims of the first project, the Community Education Intervention (CEI), remain unchanged. They are to: (1) determine community knowledge and attitudes about environmental health hazards and what can be done to prevent or reduce them; (2) develop and implement strategies to teach community residents and organizations in Northern Manhattan about environmental hazards and what can be done to prevent or reduce them; and (3) assess the degree to which the intervention reaches members of the community and changes the behavior of those exposed.

The second project will consist of an Indoor Pollution and Allergen Control Intervention (IPAC) in the households of families enrolled in the Mothers and Newborns Study to reduce exposure to environmental agents associated with the development of asthma and allergies in early childhood. Our specific aims are to: (1) test the efficacy of an intervention to reduce household levels of environmental tobacco smoke (ETS) and the three allergens (cockroach, rodent, and dust mite), and increase plasma levels of the antioxidant vitamins A, C, and E; (2) assess the association between changes in household exposures to these agents and their biomarkers in children; and (3) determine whether reduction in household exposures to these agents or increases in plasma levels of antioxidants are associated with prevention or reduction of chronic respiratory symptoms.

Progress Summary:

CEI

During Year 2, we revised the initial themes and messages of the Healthy Home, Healthy Child community campaign based on the findings from 14 focus groups conducted during Y ear 1. Initially, we had identified five strategies for keeping children healthy, preventing asthma, and promoting growth and development based on current knowledge of environmental health. These strategies were:

To further explore the responsiveness of the community to these topics and develop campaign materials, 14 focus groups were conducted during Year 1 with residents of the South Bronx, Harlem, and Washington Heights. Participants were recruited through flyers, street outreach, and the community contact networks of West Harlem Environmental Action (WE ACT) and other community partner groups. A total of 103 women participated in the focus groups, with an average of eight women per group. The women ranged in age from 18-50 years and had been living in the study area from 2-45 years. Fifty-six of the women (54%) were African-American and 47 were Hispanic. The focus groups lasted from 1.5 to 2 hours each. The women were asked questions about child health issues and environmental concerns.

Overall, the women who participated in the focus groups expressed a broad view of “environment” and associated health issues. They felt issues such as garbage collection, rodent control, the sale and use of illegal substances, and even gentrification fell within the category of environmental concerns. The women felt that aside from addressing environmental concerns, there is a need to improve the “quality of life” of Harlem, Washington Heights, and South Bronx residents. Participants reported being most concerned about the following issues: safe and clean places for their children to play, clean water, clean air, garbage, rodents, drug use and sales, and poor housing quality.

As a result of this new information, we added two themes to the campaign: managing garbage properly and fighting drug and alcohol abuse. In addition, because of increasing concerns among Center scientists about exposures to pesticides in our study cohort, we modified our theme of pest control (rodents and cockroaches) to focus on how to control these pests safely. The final list of campaign themes for “Healthy Home, Healthy Child: The Truth About the Environment and How to Make it Safe” is:

To assess awareness of these issues and evaluate the impact of the campaign, we developed a brief questionnaire that focused on women’s knowledge of the environmental health risks addressed in the Healthy Home, Healthy Child campaign and on actions they could take to keep their children safe from harm. The questionnaire was administered to 556 women, aged 18-35, living in Northern Manhattan and the South Bronx. The women were interviewed in prenatal clinics and public parks. Knowledge that exposure to lead was dangerous to children was universal (99.8%) and 82 percent of the women knew that their child should be tested for lead exposure by their first birthday. We believe these findings reflect the extensive anti-lead exposure activities in New York City conducted over the last decade by the New York City Health Department and private organizations. It was notable, however, that knowledge of how to protect against lead exposure was not extensive. Although 87 percent knew to remove peeling paint chips, only one- third volunteered that cleaning the home to remove lead dust was a preventive step, and less than 10 percent named steps such as having a child wash hands after playing, letting tap water run until cold before drinking, and not using hot tap water for cooking. These findings suggest that despite high awareness of the risk of lead exposure, there is considerable room for improving women's knowledge and skills for preventing exposure in their homes. Similar findings were found for pesticides: Virtually all women (99.6%) said that pesticides used to kill cockroaches were harmful, but only 3 percent said that they protected themselves from this risk by not using pesticides at all. Only 37 percent said they stored pesticides where children could not reach them, and 35 percent reported cleaning the house or its contents after a pesticide application.

The Healthy Home, Healthy Child campaign will involve widespread distribution of written materials as well as public forums, public service announcements on the radio, articles in community newspapers, and outreach to community organizations over the next 18 months. The Earth Crew, a rotating group of high school students who participate in a year-round internship program at WE ACT, will distribute education materials in public places throughout Northern Manhattan and the South Bronx . The survey will be repeated during the same months in the same locations in 2001 to evaluate the impact of the campaign on women’s awareness of these issues and actions taken to implement campaign ideas.

IPAC

The Household Intervention is scheduled to begin during the fall of 2000 as the first children enrolled in the Mothers and Newborns study reach the age of 2 years (see R827027C002 and R827027C003 ). We plan to enroll 120 (30%) children aged 2 years with the highest potential for asthma and allergic disease. Allergic potential will be determined from scores for total IgE, and cockroach-, rodent-, or dust mite-specific IgE at age 2 . Enrolled families will be randomly assigned to treatment or control status. We will intervene in treatment group households to: (1) clean and seal the apartment and the child’s bedding to reduce cockroach, rodent, and dust mite allergen; (2) supplement the children with a multivitamin preparation that includes antioxidant vitamins A, C, and E; and (3) 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 ETS in the home. Control group families will be given a placebo intervention that includes a single session of counseling and written materials about reducing exposure to ETS. (At the end of the intervention, the control group families will be given the antioxidant vitamins.)

Significance

The primary significance from the results of the CEI focus groups held over the past years is the finding that community members define the “environment” broadly, including a variety of quality of life issues. The health and environmental concerns identified by the investigators and community residents overlap, but differ in important ways. Creating a campaign that is successful in educating and motivating community residents to change their environment will involve striking a successful balance between the two perspectives.

Project-Generated Resources

The CEI study has generated written healtheducation materials for distribution in the community.

Future Activities:

The CEI Campaign will be implemented throughout the year. Evaluation of the campaign will begin at the end of Y ear 3 in August 2001. The IPAC intervention will begin enrolling families in September 2000 when we have a cohort of 20 children aged 2 years to screen for elevated levels of allergen-specific IgE from the Mothers and Newborns S tudy. We have one minor change in protocol: Based on the recommendation of our Scientific Advisory Board, children will be enrolled on the basis of IgE scores for the specific allergens mentioned above, but not total IgE.

Supplemental Keywords:

children, exposure, asthma, PM, particulate matter, ETS, allergen, infants, community intervention. , Air, Scientific Discipline, Health, RFA, Susceptibility/Sensitive Population/Genetic Susceptibility, Biology, Risk Assessments, genetic susceptability, Health Risk Assessment, Children's Health, particulate matter, Environmental Chemistry, Allergens/Asthma, environmentally caused disease, environmental hazard exposures, low income community, allergen, health effects, inhalation, respiratory problems, dust , dust mite, assessment of exposure, dust mites, human health risk, outreach and education, toxics, cockroaches, community-based intervention, sensitive populations, biological response, airway disease, biological markers, children, school based study, asthma, human exposure, Human Health Risk Assessment, model, PM
Relevant Websites:

http://www.mailman.hs.columbia.edu/ccceh/index.html exit EPA

Progress and Final Reports:
Original Abstract
2001 Progress Report
2002 Progress Report


Main Center Abstract and Reports:
R827027    CECEHDPR - Columbia University School of Public Health

Subprojects under this Center: (EPA does not fund or establish subprojects; EPA awards and manages the overall grant for this center).
R827027C001 Community-Based Intervention: Reducing Risks of Asthma
R827027C002 Growth and Development/Evaluation of Carcinogenic Risks
R827027C003 Research Project on Asthma

Top of page

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.

Local Navigation

Jump to main content.