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2002 Progress Report: Community-Based Intervention: Reducing Risks of Asthma
EPA Grant Number: R827027C001Subproject: 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: August 1, 2001 through July 31, 2002
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 project has two objectives, one focused on educating women living in Northern Manhattan about environmental risks to children's health, and the other focused on integrated pest management to reduce pests and allergens in the home. 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 aim of the second project, the Indoor Pollution and Allergen Control Intervention (IPAC) is to evaluate the impact of a building-wide Integrated Pest Management (IPM) program that represents a collaboration between the New York City Department of Health (NYCDOH), the NYC Housing Authority (NYCHA), and the Columbia Center for Children's Environmental Health (CCCEH).
Progress Summary:Studies and Results:
The IPAC program is based on the EPA-funded pilot IPM project conducted by
NYCDOH and NYCHA at Lehman Houses in East Harlem. With funding from New York
City, it is being extended to public housing located in Central and East
Harlem, the South Bronx, and Northern Brooklyn. The program involves a community-based
approach to providing IPM for entire buildings in both public spaces and
private
apartments. NYCHA hires and trains traditional Pest Control Operators from
the community to perform IPM. The IPM intervention includes: (a) repair of
cracks, holes, and water leaks; (b) intensive cleaning to reduce existing
allergen levels; (c) use of low toxicity pest control measures (gels and
bait stations)
to reduce cockroach populations; (d) education for the family about how to
maintain the IPM intervention; and (e) educational meetings for building
residents. NYCDOH and CCCEH are collaborating in a controlled evaluation
of the intervention.
Because NYCDOH does not have the expertise or finding to conduct a hill-scale
evaluation of the intervention's impact on pest populations and allergen
levels in the home, CCCEH has partnered with them to add our expertise in
dust sampling
for allergen exposures, assessing respiratory symptoms in apartment residents,
and testing hypotheses about the relationships of pest populations, allergen
exposure, and respiratory symptoms.
For the evaluation, the Investigators now plan to enroll a larger sample. Up to 200 apartments per development will be enrolled: 100 intervention apartments and 100 control apartments that will receive a delayed intervention. They will work with the DOH to collect data from each participating household at baseline, 3 months, and 6 months following the intervention for intervention apartments and before the intervention for control apartments. They will evaluate the impact of the program on pest populations using glue traps for cockroaches and census block baits for mice. Impact on allergen levels will be evaluated by collecting vacuumed dust samples from the kitchen floor and beds. Impact on pesticide levels, which are expected to decrease as low toxicity gels and bait stations are used in place of sprays, and impact on respiratory symptoms of any family member with asthma or asthma symptoms will be assessed through interviews with the head of household. Urine for pesticide analysis will not be collected as NYCHA objected to this component of the evaluation. They will test the hypothesis that this community-based, building-wide intervention will reduce pest populations and allergen levels in intervention apartments, and reduce respiratory symptoms in children and adults residing in the apartments.
All interviews will be conducted and data collected by research workers using hand-held computers. This method should benefit participants and the evaluation team by minimizing time spent in participants' homes and eliminating the need to key in paper-based data. Enrollment of study participants began in July in the Metro North and White public housing developments in East Harlem and is ongoing.
CEI - The Center's collaboration with its Community Advisory Board (CAB) grew in the last year to fully encompass the health educator work force on staff at each of the nine participating neighborhood organizations from the CAB to conduct its Healthy Home, Healthy Child (HHHC) Community education campaign in local communities through group workshops, individual home visits and community health fairs. A health educator has been hired as a part-time coordinator of the campaign and trains the CA.B health educators to deliver workshops on the seven Healthy Home Healthy Child environmental health campaign topics to groups of clients at their own organizations, as well as other neighborhood groups such as churches, tenant and homeowner organizations, block associations, child care and WIC centers, PTAS, after school programs and foster care agencies. The focal audience is mothers and other primary caretakers of young children. Close to 50 HHHC presentations have been made since the initial round of trainings in January 2002, and health educators are incorporating HHHC topics, such as pesticides and nutrition, into their regular curricula. The Center has been invited to train additional staff of home visitors and other health outreach workers at its partnering community organizations in delivering the HIIHC educational campaign and in techniques for integrating the information into their normal work activities. An evaluation tool is currently being developed to assess the effectiveness of community workshops led by the CAB organizations' staff health educators. The evaluation component is essential to understanding the degree to which the HHHC presentations are effective at communicating messages to intended audiences, and the accuracy with which the information is comprehended. In addition to training CAB health educators, the Center sponsored an extensive training this year of over 60 health educators on staff at 25 area health service and environmental advocacy organizations.
Future Activities:The IPAC intervention will enable us for the first time to determine whether a community-based, building-wide IPM intervention in public housing can reduce pest populations and allergen levels in the home, and whether these reductions have an impact on the frequency of respiratory symptoms in children. Our HHHC campaign is now involving our CAB organizations more directly, thus extending the reach of the campaign and deepening our community partnerships.
The CEI Healthy Home, Healthy Child Campaign will continue to be implemented throughout the year with evaluation occurring simultaneously. The IPAC study evaluating IPM in public housing will continue to enroll families.
Publications and Presentations:
Please refer to the main center progress report.
Supplemental Keywords:Allergens/Asthma, Biochemistry, Ecological Risk Assessment, Epidemiology, Human Health Risk Assessment, age-related differences, air pollutants, air toxics, airborne urban contaminants, airway disease, airway inflammation, ambient particulates, asthma, asthmatic children, children's environmental health, community-based intervention, disease, environmental health, human exposure, New York, environmental education. , 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:
Columbia Center for Children's Environmental Health
http://es.epa.gov/ncer/centers/cecehdpr/98/columbia/
Progress and Final Reports:
2000 Progress Report
2001 Progress Report
Original Abstract
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