Particulate Reduction Education in City Homes
Condition: Asthma
MeSH terms: Asthma
Study type: Interventional
Phase: Phase 3

Summary: 
      The purpose of this study is to conduct a randomized controlled trial of the efficacy of a
      combination of HEPA room air cleaners plus an ETS reduction behavior training as compared to
      either HEPA air cleaners plus standard asthma education or delayed HEPA air cleaners and
      standard asthma education (control group).
    

Detailed description: 
      150 children aged 6-12 years who reside in Baltimore and have a smoker in the household are
      to be enrolled in this study. All children will be randomized into three groups: HEPA air
      cleaners plus ETS/Indoor particulate behavior management, HEPA air cleaners and a standard
      asthma education and a standard asthma education group with delayed HEPA filter use. The HEPA
      air cleaner plus ETS/Indoor particulate behavior management intervention group will receive
      four home visits by a health coach to assess motivation for parental behavior change and then
      assist the parent to reduce/eliminate their child's exposure to ETS in the home. The
      intervention is based on the social cognitive theory that utilizes behavior modification
      techniques (e.g., modeling, reinforcement, self-monitoring, feedback and rehearsal) to change
      health behaviors. Families in this group and the HEPA air cleaner only group will receive two
      HEPA air cleaners to use over the 6-month follow-up period and three home visits for standard
      asthma education. Use of air cleaners will be electronically monitored to determine level or
      "dose" of air cleaning used by families. The standard asthma education group (delayed HEPA
      Filter group) will receive three home visits to deliver basic asthma education. All children
      receive a baseline home inspection, 7-day home PM exposure monitoring, home dust allergen
      collection, skin testing, urine cotinine, spirometry, serum eosinophilia and exhaled NO
      testing. Caregivers of each child will be interviewed at baseline and at the 6-month
      follow-up regarding ETS reduction behaviors in the home, symptom frequency, asthma control,
      other environmental exposures and health care utilization outcomes. The primary outcome for
      this study is reduction in PM10 and PM2.5 over the 6 month follow-up. Secondary outcomes
      include ETS reduction behavior change (i.e. smoker is smoking outside of home, child not
      sitting with smoker, reduction in number of household smokers), symptom free days and health
      care utilization measures. If successful, this intervention could have significant clinical
      and public health applications for pediatric asthma management in children with persistent
      asthma and high ETS home exposure.
    

Intervention name(s): Health Coach and HEPA Air cleaners; Health Coach and HEPA air cleaners
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Health Coach for ETS reduction in home and 2 HEPA air cleaners; Behavioral training and 2 HEPA air cleaners
Other intervention name(s): Behavior and HEPA; Behavior and HEPA
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Prevention
Keywords: Asthma; persistent; children; particulates; ETS