Milwaukee Day Cares Indoor Air Quality Assessment and Educational Response Study

Study Overview
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Brief Summary
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This CTSI pilot study will assess for benefit of a community health worker or nursing student taught green cleaning curriculum (developed by the local asthma coalition) provided to Milwaukee County day care staff. Consumer grade indoor air quality monitors will be deployed before and after the educational intervention to objectively monitor changes as a result of the intervention. Surveys regarding changes in cleaning practices by day care staff will also be obtained to assess changes resulting from the intervention.

Detailed Description
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A research and community service partnership of the Medical College of Wisconsin, the Univ. of Wisconsin-Milwaukee School of Nursing and the non-profit asthma coalition Fight Asthma Milwaukee Allies (FAM) was developed to describe and improve health relevant air quality conditions within urban Milwaukee daycare environments. Daycare air quality and the ability of education to improve air quality, both within Milwaukee and elsewhere, has not been extensively studied nor addressed in Wisconsin state law to date. This project aims to understand the levels of indoor organic pollution and fine particles in the air, as well as temperature and humidity with using inexpensive, consumer-grade, internet cloud enabled continuous indoor air quality (IAQ) monitors. These air quality variables are scientifically established important risk factors for both the development and exacerbation of asthma. This project aims to train UWM Nursing students, FAM Allies volunteers and MCW staff to teach an established educational programing curriculum developed by FAM Allies to daycare staff. Daycare programs may be motivated to participate in study as the curriculum is approved continuing education credits for daycare staff members. The FAM Allies curriculum will address understanding of the importance of asthma and IAQ with irritant reduction measures, and safer cleaning and pest-control techniques. Additionally, the program will review the importance of IAQ upon the lungs and review knowledge about asthma. The proposal is a 4-month intervention in which the IAQ monitor will be placed in daycares to obtain baseline measurements. Half of the facilities will receive education at the second month allowing the team to assess before and after education air quality readings. The rest of the facilities will receive the same education at the third month. After 4 months, the devices will be removed from the facilities and results in aggregate will be shared with the daycare.

Official Title
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Milwaukee Day Cares Indoor Air Quality Assessment and Educational Response Study

Conditions
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Pollution; Exposure

Intervention / Treatment
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* Other: Educational Programming


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: licensed child day care staff within Milwaukee County authorized consent to participate in study by day care organization Exclusion Criteria: medical or adult day care centers

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Sequential Assignment
Interventional Model Description: stepped wedge
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Early Intervention<br>Educational curriculum will be delivered earlier in the timeframe after IAQ monitoring has initiated. | Other: Educational Programming<br>* Green Cleaning educational programming to day care staff.<br>|
| Other: Late Intervention<br>Educational curriculum will be delivered later in the timeframe after IAQ monitoring has initiated. | Other: Educational Programming<br>* Green Cleaning educational programming to day care staff.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Alterations in total Volatile Organic Compounds (tVOC) temporally associated with the educational intervention | Assessment of tVOC levels (ppb) before and after educational intervention, reduction an intended effect of the curriculum | baseline through 4 months | 
| Alterations in particulate matter (PM2.5) temporally associated with the educational intervention | Assessment of particulate matter 2.5um levels (PM2.5, ug/m3) before and after educational intervention; reduction an intended effect of the curriculum | baseline through 4 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Assessment of Cleaning Practices (including VOC generation) practice changes associated with the Educational Intervention | Quantitative before/after surveys of Day Care cleaning behavior practices before the educational intervention and up to 4 months following, via survey inventories (practice frequencies assessed with 5 tiers survey, range: everyday to never); completed by a single designated Day Care administrator | before educational curriculum, up to 4 months following educational intervention | 
| Assessment of Perceived Obstacles to Cleaning Behavior Change | Survey-based assessment of beliefs about Obstacles to Cleaning Behavior Change (ranked survey with 8 domains, scale 1-8 of importance); all child care staff participating in educational intervention | immediately following educational intervention | 
| Assessment of Percieved Quality of Educational Program | Survey-based assessment of beliefs about Quality of Educational Program (survey with ranked scale poor/neutral/good, 5 domains), pre-specified subgroup analysis based upon teacher type (nursing student, Americorp worker, professional asthma educator) | immediately following educational intervention | 
| Baseline Description of Day Care Indoor Air Quality tVOC | Assessment of tVOC (ppb) averages and range before educational interventions; observed values before curriculum to establish baseline values in community, to assess if elevated values are associated with specific cleaning behaviors discouraged in the educational curriculum | period of time before educational intervention (1-2 months) | 
| Baseline Description of Day Care Indoor Air Quality PM2.5 | Assessment of PM2.5 (ug/m3) averages and range before educational interventions; observed values before curriculum to establish baseline values in community, to assess if elevated values are associated with specific cleaning behaviors discouraged in the educational curriculum | period of time before educational intervention (1-2 months) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Child Day Care Centers, Indoor Air Quality, Educational Intervention