Grantee Research Project Results

Final Report: From Home to School: Tribal Indoor Air Quality Intervention Study

EPA Grant Number: R835596
Title: From Home to School: Tribal Indoor Air Quality Intervention Study
Investigators: Shaughnessy, Richard J , Khan, Sohail
Institution: University of Tulsa , Navajo Nation - EPA and Dept. of Diné Education , Nimiipuu Health , Institute for Tribal Environmental Professionals , University of Oklahoma , Cherokee Nation Environmental Program and Health Services
Current Institution: University of Tulsa , Cherokee Nation Environmental Program and Health Services , Institute for Tribal Environmental Professionals , Navajo Nation - EPA and Dept. of Diné Education , Nimiipuu Health , University of Oklahoma
EPA Project Officer: Hahn, Intaek
Project Period: June 1, 2014 through May 31, 2018
Project Amount: $919,988
RFA: Science for Sustainable and Healthy Tribes (2013) RFA Text | Recipients Lists
Research Category: Tribal Environmental Health Research , Human Health

Objective:

To study the impact of home and school targeted education and reduction of asthma triggers on asthma symptoms related to tribal home and school childhood exposures. The study aimed to demonstrate the importance of an education-based approach focused on targeted cleaning and asthma trigger reduction.

An observational pre-test/post-test study with a case-control design was employed to determine the impact of targeted education on asthma trigger reduction, asthma control test results, and respiratory and other illnesses. The assessments included both school and home environments for a more complete profile of total exposure of the tribal children throughout the day.

Identification of Traditional Ecological Knowledge (TEK) was considered an important part of the study plan. The details gathered by tribal project partners were factored into the education-based approach. The approach was aimed to provide a deeper understanding and respect for the living and nonliving interactions in and between school and home environments that is the hallmark of TEK.

Summary/Accomplishments (Outputs/Outcomes):

Asthma control test scores improved significantly among children in both study and control homes. The improvement in control homes is hypothesized to be partially attributable to increased awareness of being observed and inadvertent attention to asthma triggers, based on the control home checklist procedure and walkthroughs of the homes. In addition, both groups had significantly increased number of asthma symptom-free days (mean increase 1.9-2.5 days during 4 weeks). Children in study homes had a larger significant decrease in respiratory illnesses.

There was no additional improvement noted among children in study schools, as compared to children in control schools. However, it was found that study schools were cleaning more effectively throughout the school year, and there was a significant association between absence rates and cleaning effectiveness, especially during the flu season. The schools that cleaned effectively throughout the flu season had significantly lower (2-3%) estimated mean absence rate as compared to schools that did not. For example, per 100 students, a 1 percent lower mean absence rate would correspond to one absence per day, which would translate to about 180 absences over the school year (i.e., an average of 1.8 days per student).

Conclusions:

Based on the results it appears that solely education-based approaches to helping families and schools deal with asthma trigger and indoor air quality issues do not definitively translate into health benefits (especially low-income families that need more than just education; perhaps more useful physical material provisions to allow them to improve conditions). In this study, education was limited to a 1-hour tutorial and handouts: the length and content of the training have to be carefully considered in order to help the families better understand and invest in what they can do. Materials developed from this project, in combination with the walkthrough checklists and simple measurements used, should be useful to accomplish improved asthma control among tribal homes and schools.

Journal Articles:

No journal articles submitted with this report: View all 10 publications for this project

Supplemental Keywords:

airborne contaminants, student attendance, cleaning, ATP (adenosine triphosphate), dust sampling, schools, asthma, allergens, Cherokee Nation, Navajo Nation, Nez Perce Tribe, Nimiipuu

Relevant Websites:

Asthma Series Home to School Exit - This site has copies of all the asthma education resources used in ITEP outreach events, including PowerPoints, activity descriptions and Asthma Walk Posters.

Progress and Final Reports:

Original Abstract

The perspectives, information and conclusions conveyed in research project abstracts, progress reports, final reports, journal abstracts and journal publications convey the viewpoints of the principal investigator and may not represent the views and policies of ORD and EPA. Conclusions drawn by the principal investigators have not been reviewed by the Agency.