Abstract

The goal of this five year research demonstration and education project is to determine if an intensive intervention using nurse home visitors can reduce asthma prevalence among children from low income households who begin wheezing in infancy. One hundred eighty infants and their parents who are Medicaid-eligible will be recruited from public health settings. About half of the children will be from minority families. Families will be randomly assigned to a nurse home visitor intervention group or a control group. In the intervention group, nurse home visitors will work with parents for one year to target allergens in the home, reduce environmental tobacco smoke, and improve the quality of maternal caregiving, particularly as it relates to asthma prevention and management. A control group will receive information related to preventing asthma. Repeated assessments of the targeted variables will be made in both groups. In addition, family history of asthma and children's IgE levels at enrollment will be assessed, since these variables are expected to interact with the targeted variables to affect outcome. Maternal psychological resources also will be assessed, as this factor has been associated with responsivity to home visitor interventions. Respiratory infections and use of anti-inflammatory medications will be monitored as possible mediating variables. All children will be followed to 4 years of age. Outcomes to be measured include asthma status, functional severity of asthma by maternal report and by cumulative symptom reports, pulmonary functions and IgE levels, quality of life and child behavioral adjustment, and health care use and costs. The principal investigator is Mary Klinnert, Ph.D., who is Chief of Pediatric Psychology at the National Jewish Center for Immunology and Respiratory Medicine and Associate Professor of Psychiatry at the University of Colorado Health Sciences Center. Co-investigators are Lanny Rosenwasser, M.D., Larry Borish, M.D., and Andy Liu, M.D.

  Funding Agency

Agency
National Institute of Health (NIH)
Institute
National Institute of Allergy and Infectious Diseases (NIAID)
Type
Research Demonstration and Dissemination Projects (R18)
Project #
5R18AI041137-03
Application #
2887423
Study Section
Allergy & Clinical Immunology-1 (AITC)
Program Officer
Adams, Ken
Project Start
1997-09-01
Project End
2002-08-31
Budget Start
1999-09-01
Budget End
2000-08-31
Support Year
3
Fiscal Year
1999
Total Cost
Indirect Cost

  Institution

Name
National Jewish Health
Department
Type
DUNS #
City
Denver
State
CO
Country
United States
Zip Code
80206

  Publications

Tamesis, Grace P; Covar, Ronina A; Strand, Matthew et al. (2013) Predictors for asthma at age 7 years for low-income children enrolled in the Childhood Asthma Prevention Study. J Pediatr 162:536-542.e2
Kaugars, Astrida Seja; Klinnert, Mary D; Robinson, JoAnn et al. (2008) Reciprocal influences in children's and families'adaptation to early childhood wheezing. Health Psychol 27:258-67
Klinnert, Mary D; Kaugars, Astrida S; Strand, Matthew et al. (2008) Family psychological factors in relation to children's asthma status and behavioral adjustment at age 4. Fam Process 47:41-61
Kaugars, Astrida Seja; Moody, Eric J; Dennis, Carey et al. (2007) Validity of the Five Minute Speech Sample in families with infants from low-income backgrounds. Infant Behav Dev 30:690-6
Klinnert, Mary D; Liu, Andrew H; Pearson, Marcella R et al. (2007) Outcome of a randomized multifaceted intervention with low-income families of wheezing infants. Arch Pediatr Adolesc Med 161:783-90
Klinnert, Mary D; Price, Marcella R; Liu, Andrew H et al. (2003) Morbidity patterns among low-income wheezing infants. Pediatrics 112:49-57
Marotta, Alex; Klinnert, Mary D; Price, Marcella R et al. (2003) Impulse oscillometry provides an effective measure of lung dysfunction in 4-year-old children at risk for persistent asthma. J Allergy Clin Immunol 112:317-22
Wamboldt, Frederick S; Price, Marcella R; Hume, Leigh A et al. (2002) Reliability and validity of a system for coding asthma outcomes from medical records. J Asthma 39:299-305
Klinnert, Mary D; Price, Marcella R; Liu, Andrew H et al. (2002) Unraveling the ecology of risks for early childhood asthma among ethnically diverse families in the southwest. Am J Public Health 92:792-8
Gereda, J E; Klinnert, M D; Price, M R et al. (2001) Metropolitan home living conditions associated with indoor endotoxin levels. J Allergy Clin Immunol 107:790-6

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