2000 Progress Report: Asthma in Children: A Community-based Intervention Project

EPA Grant Number: R826708C001
Subproject: this is subproject number 001 , established and managed by the Center Director under grant R826708
(EPA does not fund or establish subprojects; EPA awards and manages the overall grant for this center).

Center: Southern California Particle Center and Supersite
Center Director: Froines, John R.
Title: Asthma in Children: A Community-based Intervention Project
Investigators: Gong, Henry , Jones, Craig , McConnell, Rob Scot
Current Investigators: Gong, Henry , Diaz-Sanchez, David , Jones, Craig , McConnell, Rob Scot
Institution: Rancho Los Amigos Medical Center , University of California - Los Angeles
EPA Project Officer: Louie, Nica
Project Period: January 1, 1998 through January 1, 2002
Project Period Covered by this Report: January 1, 1999 through January 1, 2000
Project Amount: Refer to main center abstract for funding details.
RFA: Centers for Children's Environmental Health and Disease Prevention Research (1998) RFA Text |  Recipients Lists
Research Category: Children's Health , Health Effects , Health

Objective:

The long-term goal of this research project is to reduce asthma incidence, prevalence, severity, and mortality among inner-city children.  We are developing and evaluating a comprehensive community intervention aimed at reducing environmental asthma triggers in the homes of children with persistent asthma who already are receiving high-quality, continuous asthma care from the Los Angeles County-University of Southern California Breathmobile, a novel, school-based mobile asthma clinic.  The specific objectives of this research project are to:  (1) determine whether a community-based, family-oriented, comprehensive environmental health education program will result in reduction in concentrations of house mite and cockroach antigens in household dust; (2) determine whether the environmental health education program results in clinical improvement in childhood asthma; (3) determine whether a professional integrated pest management and cleaning program provides greater reduction in exposure to household antigen or improvement in clinical status than health education alone; and (4) expand coverage of successful indoor air pollutant reduction strategies at low cost by the agencies and community groups participating in the study.

Progress Summary:

Health Education

Based on our early review of available popular health education materials for reducing exposure to indoor allergens, we developed a whole new set of materials for use in training our families because there were none that were entirely appropriate for our inner-city population without requiring major modification.  The core of the educational effort is a flip chart and accompanying training manual for families in a comic book style format.  We were supported in developing these materials by the Asthma and Allergy Foundation of America (AAFA), Los Angeles chapter, and we are in negotiation for additional funding to print copies of the manual beyond what is needed for the study to distribute widely through the AAFA network.

We also have begun to develop pilot activities for the second phase of this study with our community partners, of which there now are three (in addition to AAFA)—Communities for a Better Environment, Hathaway Children and Family Services, and (new since last year) Esperanza Community Housing Corporation.  Our five field staff members come from the network of community health educators supported by or affiliated with these organizations, and we are training these organizations into a larger network of educators, in preparation for meeting Objective 4 (in Years 3 to 5 of this intervention).

Professional Cleaning and Cockroach Control

We have provided staff support for subject recruitment and advice on protocol development and data analysis of another study run by the principle investigator, which is serving to pilot test and refine methods for our professional intervention.  We are completing data collection from repeated dust sampling for allergens in 60 homes of allergic children; these homes have cockroaches and were treated and cleaned professionally 1 year ago.  These data are under analysis and will be used to refine the protocol for addressing Objective 3 (which will be evaluated as part of the second phase of the study, rather than in the initial phase, as originally proposed).

We continue to be several months behind our timeline, but we are confident that we will be able to initiate the larger scale community intervention in Years 4 and 5, even if we have not completed data analysis for all data from the first phase.

Significance

Results to date are still under analysis.  We have gained valuable experience from the pilot study that is almost completed, and field data collection is under way for the 2-year study in Phase I to answer Objectives 1 and 2.

Future Activities:

We expect to finish analysis of the data from the professional cockroach treatment and cleaning pilot study and to complete and analyze results from the first year of our intervention during the next 12 months.


Journal Articles on this Report : 6 Displayed | Download in RIS Format

Other subproject views: All 11 publications 9 publications in selected types All 9 journal articles
Other center views: All 92 publications 63 publications in selected types All 61 journal articles
Type Citation Sub Project Document Sources
Journal Article Gauderman WJ, McConnell R, Gilliland F, London S, Thomas D, Avol E, Vora H, Berhane K, Rappaport EB, Lurmann F, Margolis HG, Peters J. Association between air pollution and lung function growth in southern California children. American Journal of Respiratory and Critical Care Medicine 2000;162(4 Pt 1):1383-1390. R826708 (2000)
R826708 (2001)
R826708 (2002)
R826708 (Final)
R826708C001 (2000)
R826708C001 (2001)
R826708C003 (2001)
  • Abstract from PubMed
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  • Journal Article Gilliland FD, McConnell R, Peters J, Gong Jr. H. A theoretical basis for investigating ambient air pollution and children's respiratory health. Environmental Health Perspectives 1999;107(Suppl 3):403-407. R826708 (2000)
    R826708 (2001)
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    R826708 (Final)
    R826708C001 (2000)
    R826708C003 (2000)
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  • Journal Article Gilliland FD, Berhane K, McConnell R, Gauderman WJ, Vora H, Rappaport EB, Avol E, Peters JM. Maternal smoking during pregnancy, environmental tobacco smoke exposure and childhood lung function. Thorax 2000;55(4):271-276. R826708 (2000)
    R826708 (2001)
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    R826708 (Final)
    R826708C001 (2000)
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  • Journal Article Harrington-Brock K, Cabrera M, Collard DD, Doerr CL, McConnell R, Moore MM, Sandoval H, Fuscoe JC. Effects of arsenic exposure on the frequency of HPRT-mutant lymphocytes in a population of copper roasters in Antofagasta, Chile:a pilot study. Mutation Research--Fundamental and Molecular Mechanisms of Mutagenesis 1999;431(2):247-257. R826708 (2000)
    R826708 (2001)
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    R826708C001 (2000)
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  • Journal Article Linn WS, Szlachcic Y, Gong Jr. H, Kinney PL, Berhane KT. Air pollution and daily hospital admissions in metropolitan Los Angeles. Environmental Health Perspectives 2000;108(5):427-434. R826708 (2000)
    R826708 (2001)
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    R826708 (Final)
    R826708C001 (2000)
    R827352 (2004)
    R827352 (Final)
    R827352C012 (Final)
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  • Journal Article McConnell R, Berhane K, Gilliland F, London SJ, Vora H, Avol E, Gauderman WJ, Margolis HG, Lurmann F, Thomas DC, Peters JM. Air pollution and bronchitic symptoms in Southern California children with asthma. Environmental Health Perspectives 1999;107(9):757-760. R826708 (2000)
    R826708 (2001)
    R826708 (2002)
    R826708 (Final)
    R826708C001 (2000)
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  • Abstract from PubMed
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  • Supplemental Keywords:

    asthma, children, health, air, exposure, children’s health, environmental chemistry, health risk assessment, susceptibility, sensitive population, genetic susceptibility, indoor air, Breathmobile, adolescents, air pollution, air quality, allergen, asthma indices, asthma triggers, biological response, childhood respiratory disease, children, children’s vulnerability, cockroaches, community-based intervention, dust, dust mite, exposure, exposure assessment, harmful environmental agents, health effects, human exposure, indoor air quality, indoor environment, minority population, respiratory, school-based study, sensitive populations,, RFA, Health, Scientific Discipline, Air, Environmental Chemistry, Health Risk Assessment, Risk Assessments, Susceptibility/Sensitive Population/Genetic Susceptibility, Allergens/Asthma, Children's Health, genetic susceptability, indoor air, Atmospheric Sciences, Biology, asthma, health effects, minority population, school based study, asthma triggers, dust mites, dust mite, sensitive populations, community-based intervention, adolescents, biological response, asthma indices, exposure, Human Health Risk Assessment, children, air pollution, childhood respiratory disease, children's vulnerablity, human exposure, harmful environmental agents, Breathmobile, dust , indoor air quality, sensitive population, allergen, exposure assessment, cockroaches, air quality, respiratory, indoor environment

    Relevant Websites:

    http://www.usc.edu/schools/medicine/research/centers_programs/cehc Exit

    Progress and Final Reports:

    Original Abstract
  • 1998
  • 1999
  • Final Report

  • Main Center Abstract and Reports:

    R826708    Southern California Particle Center and Supersite

    Subprojects under this Center: (EPA does not fund or establish subprojects; EPA awards and manages the overall grant for this center).
    R826708C001 Asthma in Children: A Community-based Intervention Project
    R826708C002 Children's Exposure to Environmental Tobacco Smoke: Changes in Allergic Response
    R826708C003 Respiratory Disease and Prevention Center