Home Air In Agriculture - Pediatric Intervention Trial (HAPI)

农业中的家庭空气 - 儿科干预试验 (HAPI)

• 批准号: 9096816
• 负责人: CATHERINE J KARR
• 金额: $ 52.89万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-07-22 至 2020-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9096816
• 关键词: Achievement; Address; Adrenal Cortex Hormones; Agriculture; Air; Allergens; Ammonia; Area; Asthma; Behavioral; Biological Markers; Caregiver Burden; Caregivers; Child; Childhood; Childhood Asthma; Clinical; Communication; Communities; Community Health; Community Outreach; Cysteine; Data; Data Collection; Decision Making; Development; Education; Effectiveness; Endotoxins; Enrollment; Evaluation; Exhalation; Exposure to; Federally Qualified Health Center; Goals; Health; Health Priorities; Home environment; Household; Housing; Indoor pollutant; Inflammation; Inflammatory; Intervention; Intervention Studies; Intervention Trial; Latino; Leukotriene E4; Leukotrienes; Life; Link; Measurement; Measures; Mediator of activation protein; Methods; Morbidity - disease rate; National Institute of Environmental Health Sciences; Neighborhoods; Nitric Oxide; Oral; Outcome; Participant; Particulate; Particulate Matter; Policy Maker; Poverty; Procedures; Process; Production; Psychosocial Stress; Public Health; Questionnaires; Randomized; Recruitment Activity; Research; Research Design; Rural; Seasons; Sleep; Source; Spirometry; Steroids; Testing; Time; Translational Research; Vulnerable Populations; Washington; aged; air cleaner; air contaminant; base; clinically relevant; community based participatory research; cysteinyl-leukotriene; design; environmental justice; experience; farm worker; follow-up; improved; innovation; meter; novel; operation; post intervention; programs; residence; urban children; urinary; wood smoke

DESCRIPTION (provided by applicant): Our community based participatory research seeks to reduce exposure to asthmagens in the homes of an environmental justice community of Latino children residing in an area of intense dairy and crop based agricultural production. These children with asthma experience high morbidity and our preliminary research finds significant effects of ambient concentrations of fine particulate matter and ammonia. Yet children spend the majority of their time indoors. Studies conducted in urban settings demonstrate that indoor particulate matter (PM) influences asthma outcomes and HEPA (high efficiency particulate air) cleaners can reduce indoor and ambient generated PM. Data on asthma in rural settings is sparse and trials incorporating HEPA portable air cleaners are lacking. This study seeks to characterize key indoor pollutant exposures for [75 children with asthma] who reside within 400 meters of crop production or dairy operations. Subject recruitment utilizes an existing community health worker delivered asthma education program operated by the region's federally qualified health center. Children aged 6-12 years with poorly controlled asthma will be randomized to the usual educational program or an enhanced version, which includes 2 portable room HEPA cleaners (child sleeping area, living room) [with filters designed to reduce PM and ammonia (NH3)]. Children in the usual program group will receive HEPA cleaners at the end of their study year. Prioritizing methods with low participant burden as well as innovative approaches, we will evaluate the effectiveness of the enhanced intervention on 1) Reducing indoor measures of PM and NH3 across seasons, 2. Improving clinically relevant measures of asthma health (Asthma Control Questionnaire, spirometer, oral steroid treatment, unscheduled clinical utilization), and 3. Reducing biomarkers of inflammation (urinary cysteine leukotriene - LTE4, exhaled nitric oxide). Caregiver psychosocial stress and behavioral components will be evaluated as mediators of these effects. The study design, procedures, translation of research results for multiple stakeholders and development of an environmental action plan to control/eliminate exposures are conducted within El Proyecto Bienestar, a longstanding UW-community research to action partnership. The project incorporates each of the NIEHS 2012-17 strategic themes and directly addresses 7 of the 11 sub goals.

描述（由申请人提供）：我们基于社区的参与性研究旨在减少居住在以乳制品和农作物为主的农业生产地区的拉丁裔儿童环境正义社区家中对哮喘原的接触。这些患有哮喘的儿童发病率很高，我们的初步研究发现环境中细颗粒物和氨浓度的显着影响。然而孩子们大部分时间都在室内度过。在城市环境中进行的研究表明，室内颗粒物 (PM) 会影响哮喘的结果，而 HEPA（高效颗粒空气）清洁器可以减少室内和环境中产生的 PM。有关农村地区哮喘的数据很少，也缺乏采用 HEPA 便携式空气净化器的试验。本研究旨在描述居住在作物生产或乳品厂 400 米范围内的 [75 名哮喘儿童] 的主要室内污染物暴露情况。受试者招募利用现有社区卫生工作者提供的哮喘教育计划，该计划由该地区联邦合格的卫生中心运营。哮喘控制不佳的 6-12 岁儿童将被随机分配到常规教育计划或增强版，其中包括 2 个便携式房间 HEPA 清洁器（儿童睡眠区、客厅）[带有旨在减少 PM 和氨 (NH3) 的过滤器]。通常项目组的孩子将在学习年结束时获得 HEPA 清洁器。优先考虑参与者负担低且具有创新性的方法 方法，我们将评估强化干预措施的有效性：1) 跨季节减少 PM 和 NH3 的室内测量，2. 改善哮喘健康的临床相关测量（哮喘控制问卷、肺活量计、口服类固醇治疗、不定期临床使用），以及3. 减少炎症生物标志物（尿半胱氨酸白三烯 - LTE4、呼出一氧化氮）。护理人员的社会心理压力和行为成分将作为这些影响的中介因素进行评估。研究设计、程序、为多个利益相关者翻译研究结果以及制定控制/消除暴露的环境行动计划是在 El Proyecto Bienestar 内进行的，El Proyecto Bienestar 是威斯康星大学社区长期研究与行动合作伙伴关系。该项目包含 NIEHS 2012-17 年战略主题中的每一个，并直接解决 11 个子目标中的 7 个。