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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 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 is structured to achieve Specific Aim 3: to test the hypotheses a) that community education can be effective in raising awareness of environmental health risks and preventive behaviors, thus in reducing the risk of asthma; and b) that individual maternal education to reduce exposure to ETS, a household intervention to reduce allergen exposures, and antioxidant supplementation will reduce the risk of asthma- related biomarkers and persistent wheeze among infants in the cohort identified as "high risk" based on elevated immunoglobulin (IgE) at 24 months. Low income communities lack adequate information or resources to prevent or reduce either community wide or personal exposures to these environmental health hazards. To address these problems the CCCEH proposes two related interventions, one at the community-level and one at the household level. Beginning in the first year', the Center will work in partnership with community organizations to develop, implement, and evaluate a communitywide intervention to increase awareness of environmental health hazards, particularly ETS and other airborne pollutants, and empower community members to take preventive action. The investigators in the Intervention Project will work with the Administrative Core in developing and disseminating information via a combination of written and audiovisual materials, and public meetings and events held in the communities of Northern Manhattan and the South Bronx. The efficacy of this community-level intervention will be assessed in the same prenatal clinics from which we draw the etiologic cohort. A single group pretest-post test research design will be used to measure penetrance of the information and resultant behavior changes. The Center will also carry out an individual-level intervention involving families from the etiologic cohort. One hundred and twenty 24- month old infants from the cohort who are identified as being at high risk of asthma (based on elevated IgE at 24 months) will be randomized either to a treatment or a control group. The mothers in the treatment group will receive one-on-one educational counseling regarding the risks of ETS and other environmental hazards, an integrated pest management intervention to reduce indoor exposure to cockroach and house dust mite allergens, and nutritional supplementation of the children with a multivitamin containing the Recommended Daily Allowances of the antioxidants (A, C, E, selenium) and Vitamin D and the B vitamins. The control group will receive written materials on reducing ETS and a multivitamin with the B-complex and Vitamin D. The infants will be followed for 12 months. The efficacy of the individual intervention will be evaluated by comparing the pre- and post-intervention levels of allergens (monitored by the Exposure Assessment Core), children's blood levels of cotinine, antioxidants (A, C and E), and IgE, as well as respiratory symptoms. The study will also attempt to determine whether the strength of the associations observed at the individual level between environmental and susceptibility factors and adverse health effects varies as a function of community-level risk factors, including socioeconomic disadvantage; and b) whether the effect of the community-based and the household based intervention also varies as a function of community-level risk factors. This work will be carried out by the Data Management, Statistics and Community Impact Modeling Core of the CCCEH. Along with data generated by the other components of the Center, indices of community-level risk, will be used to conduct multilevel analyses and hierarchical linear modeling. Thus, the Community Impact Modeling Unit enables the CCCEH to take an integrated approach to understanding the complex etiology of developmental impairment and asthma. Another aim is to work in partnership with the community in all phases of the etiologic and intervention research, as well as in communicating the research results and their implications for policy. The community is an integral component not only of the research projects and design, but in the organizational structure of the CCCEH. The Administrative Core of the Center houses the Community Outreach and Education Program (COEP). The purpose of this program is to ensure active participation in research design and information dissemination. 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
Progress and Final Reports:
2000 Progress Report
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