In preliminary analysis of the home based environmental intervention trial currently being conducted by the Center, we have found that indoor airborne PM was reduced by 31-42% and that cockroach allergen was reduced 45%. Building on this success we will test an intervention that is heavily behavioral, intended to reduce particulate sources and increase use of room air filters. This CPBR randomized controlled intervention trial is designed to compare the effectiveness of a targeted home-based particulate and allergen control behavioral education program to a traditional office-based education in decreasing home allergen and particulate levels and asthma symptoms in asthmatic children and who are exposed to ETS on a regular basis in their home. We will recruit 120 children aged 6-12 years with currently active asthma who report regular ETS exposure in the home. Each child and their family will undergo a baseline evaluation that will include questionnaires, allergy skin tests, spirometry, and a home visit to evaluate particulate and allergen control behaviors and settled dust allergen measurements. After receiving traditional particulate and allergen control education in a clinic setting, participants will be randomized to a Usual Care Group or an Intervention Group. The Intervention Group will receive a home-based behavioral education and coaching program provided by trained environmental health coaches. The intervention will be tailored to the individual particulate and allergen exposure profile of each child. Particulate control interventions will target the child's particulate exposure risk profile based on the home evaluation data. Allergen control interventions will address environmental exposure to dust mites, cockroaches, cats and dogs. Telephone interviews will evaluate symptoms and behaviors at 3, 6, 9 and 12 months post randomization. The primary outcome will be change in particulate levels and target environmental allergens in the home and change in asthma-related quality of life. Secondary outcomes include adherence with environmental control recommendations, rhinoconjunctivitis-related quality of life, FEV1, changes in other environmental allergens and particulates, self-efficacy for environmental allergy, and particulate control and healthcare utilization.
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