AQI and Childhood Asthma: an Intervention

  • STATUS
    Recruiting
  • participants needed
    80
  • sponsor
    University of Pittsburgh
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Updated on 19 February 2024
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asthma
persistent asthma
childhood asthma

Summary

This is a small pilot prospective intervention trial in children with asthma who will be randomized to receive either (A) Air Quality Index (AQI) education + an asthma action plan (control) or (B) AQI education + an asthma action plan which contains AQI behavioral recommendations + demonstrate ability to navigate to AirNow either online or on smartphone app (intervention).

Description

Over 3 million US children with asthma reported at least one attack in the prior year. Poorly controlled asthma is a major cause of suffering, school absences, loss of caregiver productivity, and healthcare costs (estimated as ~$80 billion/year). Over half of children on controller medication are not well controlled, due to environmental exposures, non-adherence, or true non-response to treatment. Outdoor air pollution is a known trigger of asthma. Although sound health policies are the best long-term approaches to reduce the harmful effects of air pollution, exposure avoidance is needed until "clean air" is ensured through effective legislation. Despite this, healthcare providers infrequently provide pollution exposure advice to children with asthma. The Environmental Protection Agency (EPA) monitors air pollution and reports a daily Air Quality Index (AQI) that is easy to use and available in most metropolitan areas. Practical recommendations regarding outdoor activity can be based on AQI levels. Despite this, AQI-based recommendations are rarely addressed in asthma action plans (AAP). No pediatric study has assessed the addition of the AQI to AAP to reduce asthma morbidity. This proposal seeks to recruit a pilot cohort of 40 children with asthma + 40 parent/guardian. Using this cohort, the investigators will test the hypotheses that (1) the addition of the AQI to AAP will reduce asthma exacerbations and (2) the addition of the AQI to AAP will improve asthma symptom control & quality of life in children with asthma. The inclusion of the AQI onto asthma action plans is novel in clinical asthma care; its wide availability would make large-scale implementation feasible. The investigators expect this low-cost and low-tech intervention will have a positive impact in reducing asthma morbidity. Given that 1 out of every 12 children in the U.S. has asthma, this is relevant to health care professionals, parents, and public health practitioners.

Optional, the investigators will collect nasal epithelial cells for use in future genomic/epigenetic studies.

Details
Condition Asthma, Asthma, Asthma (Pediatric), Allergies & Asthma, Asthma (Pediatric), Asthma in Children, Allergies & Asthma
Age 8years - 17years
Treatment Routine Care, AQI intervention
Clinical Study IdentifierNCT04454125
SponsorUniversity of Pittsburgh
Last Modified on19 February 2024

Eligibility

 Yes No Not Sure

Inclusion Criteria

Child Inclusion criteria includes
physician diagnosis of persistent asthma- either mild, moderate, or severe
family home internet access and/or smartphone access + willingness to download AirNow app on phone
age 8-17 years
Parent/guardian inclusion: parent or guardian of the child participant, of
whom has met inclusion criteria

Exclusion Criteria

Child exclusion criteria includes
diagnosis of other chronic respiratory disease (e.g. cystic fibrosis, bronchopulmonary dysplasia, etc)
immunodeficiency- acquired or congenital
neuromuscular disease
disability affecting ambulation
cyanotic congenital heart disease
only 1 child per household eligible
no plans to leave Pittsburgh area in next 6 months
Parental/guardian exclusion criteria: none
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