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Br J Gen Pract. 2011 Nov;61(592):e724-32. doi: 10.3399/bjgp11X606636.

Enhancing ventilation in homes of children with asthma: pragmatic randomised controlled trial.

Author information

1
Public Health Wales, Wrexham, UK. louise.woodfine@wales.nhs.uk

Abstract

BACKGROUND:

Few robust studies have tested whether enhancing housing also improves health.

AIM:

To evaluate the effectiveness of installing ventilation systems, and central heating where necessary, in the homes of children with moderate or severe asthma.

DESIGN AND SETTING:

Pragmatic randomised controlled trial (RCT) in homes within Wrexham County Borough, Wales, UK.

METHOD:

A pragmatic RCT was carried out, of a tailored package of housing improvements providing adequate ventilation and temperature, following inspection by a housing officer. One hundred and ninety-two children with asthma aged 5 to 14 years, identified from general practice registers, were randomised to receive this package, either immediately or a year after recruitment. At baseline, and after 4 and 12 months, parents reported their child's asthma-specific and generic quality of life, and days off school.

RESULTS:

The package improved parent-reported asthma-specific quality of life significantly at both 4 and 12 months. At 12 months, this showed an adjusted mean difference between groups of 7.1 points (95% confidence interval [CI] = 2.8 to 11.4, P= 0.001): a moderate standardised effect size of 0.42. The generic quality-of-life scale showed reported physical problems were significantly reduced at 4 months, but not quite at 12 months, when the mean difference was 4.5 (95% CI = -0.2 to 9.1, P= 0.061). The improvement in psychosocial quality of life at 12 months was not significant, with a mean difference of 2.2 (95% CI = -1.9 to 6.4, P= 0.292). Parent-reported school attendance improved, but not significantly.

CONCLUSION:

This novel and pragmatic trial, with integrated economic evaluation, found that tailored improvement of the housing of children with moderate to severe asthma significantly increases parent-reported asthma-related quality of life and reduces physical problems. Collaborative housing initiatives have potential to improve health.

PMID:
22054336
PMCID:
PMC3207090
DOI:
10.3399/bjgp11X606636
[Indexed for MEDLINE]
Free PMC Article
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