Aggravating Factors of Asthma in a Rural Environment

农村环境中哮喘的加重因素

• 批准号: 8105139
• 负责人: CATHERINE J KARR
• 金额: $ 30.37万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-24 至 2013-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8105139
• 关键词: Address; Adult; Affect; Agricultural Workers; Agriculture; Agrochemicals; Animal Feed; Animals; Asthma; Breathing; Cellular Phone; Child; Clinic; Clinical; Collaborations; Communication; Communities; Community Health; Community Health Education; Computer software; Data; Data Collection; Development; Dictyoptera; Dust; Education; Educational Curriculum; Enrollment; Environment; Environmental Risk Factor; Evaluation; Exhalation; Exposure to; Family; Growth; Guidelines; Health; Health Priorities; Hispanics; Home environment; Hour; Humulus; Impact evaluation; Individual; Instruction; Irritants; Livestock; Location; Maps; Measurement; Measures; Molds; Monitor; Morbidity - disease rate; National Heart, Lung, and Blood Institute; Nature; Nitric Oxide; Observational Study; Outcome; Paper; Participant; Patient Self-Report; Patients; Peak Expiratory Flow; Pesticides; Pharmaceutical Preparations; Phase; Pollen; Procedures; Process; Production; Property; Protocols documentation; Provider; Radio; Recording of previous events; Reporting; Role; Rural; Sampling; Severities; Source; Spirometry; Students; Surveys; Symptoms; Telephone; Testing; Time; Tobacco smoke; Training; Translating; Translational Research; United States; Universities; Urban Population; Washington; Work; aged; air sampling; airborne allergen; base; chemical allergen; cohort; community organizations; experience; farm worker; innovation; meter; methacholine; outreach; outreach program; peak flow measurement; pollutant; prevent; programs; public health relevance; response; skin prick test; tool; toxicant; trafficking; wasting

DESCRIPTION (provided by applicant): Asthma and factors that aggravate asthma in the rural setting are key health priorities identified in an ongoing community-academic partnership, Proyecto Bienestar (PB). This longstanding partnership is a collaboration between the Northwest Community Education Center (NCEC)/KDNA Radio, the Yakima Valley Farm Workers Clinic (YVFWC), Heritage University and the University of Washington (UW). Preventing exacerbations is the most important challenge in asthma treatment and national guidelines recognize the role of indoor environmental factors and traffic-related pollutants. This project addresses an important data gap regarding the role of ambient environmental factors that affect a rural Hispanic population, where asthma morbidity is disproportionately high. In the first phase of the project we will geo- temporally locate episodes of asthma aggravation among a cohort of clinically confirmed asthmatics and utilize geographic information software to map the distribution of agricultural processes that may be responsible for triggering these episodes. The most common suspected ambient triggers will be prioritized. Guided by the timing of the suspected agricultural processes and the reported episodes, sampling with an innovative multi channel sampler will be done with a grid of community-based monitors which will sample air for the suspected aggravators. The asthmatic cohort will continue to be followed into year three. Analysis will focus on concentrations of the suspected triggers which will be compared to reports of new asthma exacerbations by subjects. An educational outreach program based on confirmed and/or strongly suspected aggravators will be developed for delivery through Radio KDNA, the YVFWC and the University of Washington. A clinician training curricula based on management of rural asthmatics will be developed and delivered to the YVFWC clinical providers and their Asthma Outreach Program community health workers. Evaluation will include process evaluation of PB, outcome evaluation of enhanced data collection and asthma management and product quantification including papers, presentations and student participants and impact evaluation of changes community response. PUBLIC HEALTH RELEVANCE: This community based project characterizes ambient triggers of asthma in the rural setting by following 50 asthmatic community subjects, geo-temporally plotting their exacerbations and comparing these with known agricultural exposures. Subsequently, ambient sampling with an innovative and adaptable sampler will confirm the nature of the exposures and an informational campaign will share the findings with the public, clinicians and the scientific community. A multifaceted evaluation will assess the process, outcomes and impact of the program on the partnership, the participants, the clinical providers and the community.

描述（由申请人提供）：哮喘和农村环境中加重哮喘的因素是正在进行的社区学术伙伴关系 Proyecto Bienestar (PB) 中确定的关键健康优先事项。这一长期合作伙伴关系是西北社区教育中心 (NCEC)/KDNA 广播电台、亚基马谷农场工人诊所 (YVFWC)、传统大学和华盛顿大学 (UW) 之间的合作。预防病情加重是哮喘治疗中最重要的挑战，国家指南认识到室内环境因素和交通相关污染物的作用。该项目解决了关于影响西班牙裔农村人口的周围环境因素的作用的重要数据差距，那里的哮喘发病率异常高。在该项目的第一阶段，我们将在一组临床确诊的哮喘患者中对哮喘加重发作进行地理定位，并利用地理信息软件绘制可能引发这些发作的农业过程的分布图。最常见的可疑环境触发因素将被优先考虑。在可疑农业过程的时间安排和报告的事件的指导下，将使用创新的多通道采样器进行采样，并通过基于社区的监测器网格对可疑的加重者进行空气采样。哮喘队列将继续跟踪至第三年。分析将集中于可疑触发因素的浓度，并将其与受试者新的哮喘恶化报告进行比较。将制定一项基于已确认和/或强烈怀疑的加害者的教育外展计划，并通过 KDNA 广播电台、YVFWC 和华盛顿大学提供。将开发基于农村哮喘患者管理的临床医生培训课程，并将其提供给 YVFWC 临床提供者及其哮喘外展计划社区卫生工作者。评估将包括PB的过程评估、加强数据收集和哮喘管理的结果评估以及产品量化（包括论文、演示和学生参与者）以及社区反应变化的影响评估。 公共卫生相关性：这个以社区为基础的项目通过跟踪 50 名哮喘社区受试者、在地理时间上绘制其恶化情况并将其与已知的农业暴露进行比较，来描述农村环境中哮喘的环境诱因。随后，使用创新且适应性强的采样器进行环境采样将确认暴露的性质，并且信息活动将与公众、临床医生和科学界分享调查结果。多方面的评估将评估该计划的过程、结果以及对合作伙伴、参与者、临床提供者和社区的影响。