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2006 Progress Report: A Randomized Controlled Trial of Behavior Changes in Home Exposure Control
EPA Grant Number: R832139C002Subproject: this is subproject number 002 , established and managed by the Center Director under grant R832139
(EPA does not fund or establish subprojects; EPA awards and manages the overall grant for this center).
Center: Johns Hopkins Center for Childhood Asthma in the Urban Environment
Center Director: Breysse, Patrick
Title: A Randomized Controlled Trial of Behavior Changes in Home Exposure Control
Investigators: Butz, Arlene
Current Investigators: Breysse, Patrick
Institution: Johns Hopkins University
EPA Project Officer: Fields, Nigel
Project Period: November 1, 2003 through October 31, 2008 (Extended to October 31, 2010)
Project Period Covered by this Report: November 1, 2005 through October 31, 2006
RFA: Centers for Children's Environmental Health and Disease Prevention Research (2003)
Research Category: Children's Health , Health Effects
Description:
Objective:The original goals of this community-base prevention project were to conduct a randomized controlled trial of the effectiveness of an environmental intervention based on home air filters and a smoking behavior modification behavioral intervention on reducing hazardous exposures and their adverse health effects.
We conducted a randomized controlled trial of methods to reduce home environmental exposure in the homes of asthmatic children living in the inner city.
Progress Summary:Progress on the New Intervention study: During this year, a protocol has been developed to extend the results of the completed RCT conducted in years 01-05. In the first intervention, PM was reduced substantially (38%) by a combination of a HEPA air filter in the child’s bedroom, mattress and pillow covers on the child’s bed, cockroach extermination and education for the family. The new intervention trial will compare increased filtration (two HEPA air filters) and an intensive behavioral intervention to reduce ETS exposure (a major source of Particulate Matter in the home). After baseline evaluation, and morbidity assessment, children with persistent asthma will be randomized into three groups: filtration plus ETS behavior change, filtration alone and standard care (delayed filtration). The trial will last 6 months. Families will be interviewed monthly to assess frequency of asthma symptoms, medication use, ER and hospitalizations as well as smoking behavior. Home visits will be conducted at baseline and 6 months to inspect the home, collect dust from the child’s bedroom for allergen analysis, and to sample airborne particulates (PM10, PM2.5, TSP. MIE) NO2, nicotine and O3. Clinic visit evaluation will be conducted at baseline and 6 months to administer questionnaires, perform spirometry and collect urine for cotinine and creatinine measurements. The primary outcome with be indoor PM10, PM2.5 and MIE. Secondary outcomes with be child’s heath and cotinine measurements. We will monitor the HEPA air filters by using passive monitors.
Airborne pollutants and indoor allergens increase asthma morbidity in inner city children;so reducing exposure, if feasible, should improve asthma morbidity.
After completion of questionnaires, FEV1 and allergen skin tests, home inspection and measurement of home air pollutants and allergens, 100 asthmatic children aged 6-12 years were randomized to a treatment (home based education, cockroach and rodent extermination, mattress and pillow encasings, and HEPA air cleaner) and control (treated at the end of the 1 year trial). Outcome was assessed with home evaluations at 6 and 12 months, clinic evaluation at 12 months and repeated telephone interviews.
Future Activities:The newly planned intervention will begin starting 9/1/2006. We are currently conducting recruitment and training of new staff. Recruitment will be made easier by the existence of a recruitment database maintained by the Data Core. This database has been approved by the Johns Hopkins University IRB and includes families who have completed other research projects conducted by Center personnel, then have signed a HIPAA waiver and have signed their consent to be included on this database. Periodic mailings serve to both maintain interest and to determine that the present address is active.
Journal Articles on this Report : 3 Displayed | Download in RIS Format
| Other subproject views: | All 27 publications | 27 publications in selected types | All 26 journal articles |
| Other center views: | All 103 publications | 103 publications in selected types | All 100 journal articles |
| Type | Citation | ||
|---|---|---|---|
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Butz AM, Tsoukleris MG, Donithan M, Hsu VD, Zuckerman I, Mudd K, Thompson RE, Rand C, Bollinger ME. Effectiveness of Home Nebulizer Education Intervention in Young Minority Children with Asthma. Archives of Pediatric and Adolescent Medicine 2006;160:622-628. |
R832139 (2007) R832139C002 (2006) R832139C002 (2007) |
not available |
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Eggleston PA, Butz A, Rand C, Curtin-Brosnan J, Kanchanaraksa S, Swartz L, Breysse P, Buckley T, Diette G, Merriman B, Krishnan JA. A randomized controlled clinical trial home environmental intervention in inner city asthma. Annals of Allergy, Asthma and Immunology 2005;95:518-524. |
R832139 (2006) R832139C002 (2006) |
not available |
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Winkelstein ML, Quartey R, Pham L, Lewis L, Lewis C, Hill K, Butz A. Asthma Education for Rural School Health Personnel: Resources, Barriers, and Outcomes. Journal of School Nursing 2006;22:170-177. |
R832139C002 (2006) R832139C002 (2007) |
not available |
ENVIRONMENTAL MANAGEMENT, INTERNATIONAL COOPERATION, Scientific Discipline, Health, RFA, Risk Assessment, Risk Assessments, Disease & Cumulative Effects, Health Risk Assessment, Ecological Risk Assessment, Children's Health, Atmospheric Sciences, Biochemistry, Environmental Policy, airborne urban contaminants, health effects, children's environmental health, age-related differences, human health risk, ambient particulates, air pollutants, air toxics, community-based intervention, environmental health, air pollution, airway disease, children, disease, asthma, human exposure
Progress and Final Reports:
2004 Progress Report
2005 Progress Report
Original Abstract
2007 Progress Report
Main Center Abstract and Reports:
R832139 Johns Hopkins Center for Childhood Asthma in the Urban Environment
Subprojects under this Center: (EPA does not fund or establish subprojects; EPA awards and manages the overall grant for this center).
R832139C001 The Epidemiology of Susceptibility to Airborne Particulates and Allergens to Asthma in African Americans
R832139C002 A Randomized Controlled Trial of Behavior Changes in Home Exposure Control
R832139C003 Mechanisms of Particulate-Induced Allergic Asthma
R832139C004 Dendritic Cell Activation by Particulate Matter and Allergen