Aggravating Factors of Asthma in a Rural Environment

农村环境中哮喘的加重因素

• 批准号: 7937907
• 负责人: CATHERINE J KARR
• 金额: $ 30.55万
• 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/7937907
• 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; Skin; 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; 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）：在农村环境中加剧哮喘的哮喘和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。这种长期存在的合作伙伴关系是西北社区教育中心（NCEC）/kDNA广播，Yakima Valley Farm Wormers Clinic（YVFWC），遗产大学和华盛顿大学（UW）之间的合作。预防加剧是哮喘治疗中最重要的挑战，国家准则认识到室内环境因素和与交通相关的污染物的作用。该项目解决了有关影响农村西班牙裔人口的环境环境因素的作用的重要数据差距，哮喘发病率不成比例。在该项目的第一阶段，我们将在时间上定位在一系列临床确认的哮喘患者中，并利用地理信息软件来映射可能触发这些事件的农业过程的分布。最常见的可疑环境触发器将被优先考虑。在可疑的农业过程和所报告的发作的时机的指导下，将使用创新的多通道采样器进行采样，以基于社区的监视器网格进行，这将为可疑的加剧者采样空气。哮喘的队列将继续遵循第三年。分析将集中于可疑触发因素的浓度，这些触发因素将与受试者的新哮喘恶化报告进行比较。将根据已确认和/或强烈怀疑的加剧者的教育外展计划通过无线电KDNA，YVFWC和华盛顿大学开发。将开发基于农村哮喘患者管理的临床医生培训课程，并将其交付给YVFWC临床提供者及其哮喘外展计划社区卫生工作者。评估将包括对PB的过程评估，增强数据收集和哮喘管理以及产品量化的结果评估，包括论文，演示和学生参与者，以及影响变化的评估社区响应。 公共卫生相关性：这个基于社区的项目是在农村环境中以50个哮喘社区对象进行的哮喘的环境触发因素来表征的，地理序列地绘制了它们的恶化，并将其与已知的农业风险进行了比较。随后，使用创新且适应能力的采样器进行的环境抽样将确认暴露的性质，并且信息运动将与公众，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对合作伙伴关系，参与者，临床提供者和社区的过程，结果和影响。