2001 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, 2000 through January 1, 2001
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:

Pilot Study—Professional Cleaning and Cockroach Control

We have completed data collection from repeated dust sampling for allergens in a pilot study of 60 homes of allergic children. These homes have cockroaches and were treated and cleaned professionally and had repeated subsequent professional treatment during up to 1 year of followup. Data analysis is nearly complete, and a manuscript is in preparation.

Phase I

Data collection continues among the 200 families in the modification of the Phase I study described in the 2000 Annual Report (without arm 3 of the intervention).  Data analysis examining several questions of interest regarding baseline characteristics of the first 100 families is underway. In a sample of these homes, repeated measurements are available of allergen levels at colocated sites within the home and at different time intervals.  Variability between old dust (behind refrigerator, above windows) is being compared to new dust in the kitchen (on counters and accessible areas), and variability between measurements of bed and bedroom floor dust samples is being compared.  Analysis of the relationship of allergen and health outcomes to intervention will begin in Year 3.  To complete subject recruitment and conduct simultaneous followup visits, it has been necessary to hire additional staff.

We have initiated an additional pilot study to examine the correlation between allergen measurement in vacuumed samples, using the traditional method for collecting indoor dust for allergen measurement and a wipe sample suitable for subjects to collect themselves.  The wipe test would be suitable for large-scale epidemiologic studies, in which it would be too expensive to make home visits.  This study is being supported by the Southern California Environmental Health Science Center, using the infrastructure of the Children’s Environmental Health Center (CEHC).

Phase II (Expansion to Broader Community) and Health Education

The core of the educational effort is a flip chart and accompanying training manual for families in a comic book style format.  Other tools developed include a coloring book for children and reinforcement messages on magnets for refrigerators.  We have made available for posting to the National Institute of Environmental Health Sciences (NIEHS) Web site for the CEHC the manual and our review of indoor allergen health education materials in Spanish and English, and these soon will be downloadable from our Web site.  We have helped develop a community coalition, which recently was funded by a state initiative to develop community-based approaches to asthma identification and treatment (described more fully under the Center’s outreach component [see the 2001 Annual Report for Agreement No. R826708, the overall report for theCenter]).  The coalition, which includes some of our community partners to the CEHC and which also uses community health workers for home visits, has relied heavily on our curriculum for training these community workers and on our materials for working with families.  The CEHC is organizing jointly with the state-funded project a series of continuing workshops on how better to control indoor allergens.  Although the state-sponsored effort is a service project, we hope to provide the evaluation component in a way that will satisfy the original goals of our proposed Phase II, originally (and currently) scheduled to begin in Year 3, even though data collection and analysis for Phase I are still underway.  The details are under negotiation.  We also have advised similar efforts in Long Beach and in Orange County.

Future Activities:

Several analyses and manuscripts are in preparation, based on data collected to date from Phase I.  We propose to build our Phase II evaluation on the community effort we have helped to establish, which has received operational funding from the state.


Journal Articles on this Report : 3 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 Berhane K, McConnell R, Gilliland F, Islam T, Gauderman WJ, Avol E, London SJ, Rappaport E, Margolis HG, Peters JM. Sex-specific effects of asthma on pulmonary function in children. American Journal of Respiratory and Critical Care Medicine 2000;162(5):1723-1730. R826708 (2000)
R826708 (2001)
R826708 (2002)
R826708 (Final)
R826708C001 (2001)
R826708C003 (2001)
  • Abstract from PubMed
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  • 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)
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  • Journal Article Li Y-F, Gilliland FD, Berhane K, McConnell R, Gauderman WJ, Rappaport EB, Peters JM. Effects of in utero and environmental tobacco smoke exposure on lung function in boys and girls with and without asthma. American Journal of Respiratory and Critical Care Medicine 2000;162(6):2097-2104. R826708 (2000)
    R826708 (2001)
    R826708 (2002)
    R826708 (Final)
    R826708C001 (2001)
    R826708C003 (2001)
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  • Supplemental Keywords:

    asthma, health, air, exposure, air, health, atmospheric sciences, biology, children’s health, environmental chemistry, health risk assessment, risk assessments, susceptibility, genetic susceptibility, indoor air, Breathmobile, human health risk assessment, 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, dust mites, 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
    http://www.usc.edu/schools/medicine/departments/preventive_medicine/divisions/occupational/occ_environmental/cehc/index.html Exit

    Progress and Final Reports:

    Original Abstract
  • 1998
  • 1999
  • 2000 Progress Report
  • 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