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Contemp Clin Trials. 2017 Sep;60:14-23. doi: 10.1016/j.cct.2017.06.008. Epub 2017 Jun 12.

The School Inner-City Asthma Intervention Study: Design, rationale, methods, and lessons learned.

Author information

1
Boston Children's Hospital, Division of Allergy and Immunology, Boston, MA, United States; Harvard Medical School, Boston, MA, United States. Electronic address: wanda.phipatanakul@childrens.harvard.edu.
2
Harvard T.H. Chan School of Public Health, Department of Environmental Health, Boston, MA, United States.
3
Harvard T.H. Chan School of Public Health, Department of Biostatistics, Boston, MA, United States.
4
Boston Children's Hospital, Clinical Research Center, Boston, MA, United States.
5
Boston Children's Hospital, Division of Allergy and Immunology, Boston, MA, United States.
6
Boston Children's Hospital, Division of Allergy and Immunology, Boston, MA, United States; Harvard Medical School, Boston, MA, United States.
7
Boston Children's Hospital, Division of Respiratory Diseases, Boston, MA, United States; Harvard Medical School, Boston, MA, United States.
8
Harvard T.H. Chan School of Public Health, Department of Environmental Health, Boston, MA, United States; Massachusetts General Hospital, Division of Pulmonary and Critical Care, Boston, MA, United States.
9
Massachusetts General Hospital, Division of Pediatric Allergy and Immunology, Boston, MA, United States.
10
University of Iowa, Department of Occupational and Environmental Health, Iowa City, United States.
11
Columbia University School of Public Health, New York, Department of Environmental Health, New York, United States.
12
Harvard Medical School, Boston, MA, United States; Harvard T.H. Chan School of Public Health, Department of Environmental Health, Boston, MA, United States; Channing Laboratory, Brigham and Women's Hospital, Boston, MA, United States.

Abstract

Asthma is the most common chronic disease of childhood in the United States, causes significant morbidity, particularly in the inner-city, and accounts for billions of dollars in health care utilization. Home environments are established sources of exposure that exacerbate symptoms and home-based interventions are effective. However, elementary school children spend 7 to 12h a day in school, primarily in one classroom. From the observational School Inner-City Asthma Study we learned that student classroom-specific exposures are associated with worsening asthma symptoms and decline in lung function. We now embark on a randomized, blinded, sham-controlled school environmental intervention trial, built on our extensively established school/community partnerships, to determine the efficacy of a school-based intervention to improve asthma control. This factorial school/classroom based environmental intervention will plan to enroll 300 students with asthma from multiple classrooms in 40 northeastern inner-city elementary schools. Schools will be randomized to receive either integrated pest management versus control and classrooms within these schools to receive either air purifiers or sham control. The primary outcome is asthma symptoms during the school year. This study is an unprecedented opportunity to test whether a community of children can benefit from school or classroom environmental interventions. If effective, this will have great impact as an efficient, cost-effective intervention for inner city children with asthma and may have broad public policy implications.

KEYWORDS:

Asthma; Environmental exposure; Inner-city; Mouse; School

PMID:
28619649
PMCID:
PMC5557648
DOI:
10.1016/j.cct.2017.06.008
[Indexed for MEDLINE]
Free PMC Article

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