The goal of this two phase study is to design and evaluate a comprehensive intervention program to reduce asthma related to morbidity for Black and Hispanic children ages 4-11 in the inner city. During Phase I, approximately 400 subjects will be enrolled at three sites: 250 from the pediatric emergency room, 50-75 from an HMO serving a large, resident- owned, middle income housing project (Co-Op City), and 40-50 from the Medical School Faculty Practice. A questionnaire will be used to assess multiple relevant factors including: allergen and respiratory irritant exposure, sleep environment, crowding, knowledge of asthma, asthma severity, and access to and quality of medical care. Forty of the subjects enrolled in the emergency room will be followed to document patterns of utilization and access, and to identify compliance issues that may be relevant to the implementation of Phase II. These children, along with 40 age and sex-matched children from the non-inner city groups will also be screened for allergic status (total and antigen - specific IgE) and will have sleep environment allergen levels measured. Phase II will be a case- controlled study involving approximately 350 patients with three primary components: education for patients and primary care providers, enhanced patient access, and linking of patients to primary care providers. The intervention phase will be managed through the existing pediatric emergency room follow-up office, staffed by a full time nurse-practitioner using a patient management computer program that provides immediate access to patient history and medical information. The Asthma Study Unit will be composed of the Directors of Pediatric Emergency Services, the Division of Allergy and Immunology, and several other existing programs including the pediatric emergency room Follow-up Office, the pediatric ambulatory pulmonary clinic, and the pediatric continuity clinic. An advisory committee will be comprised of these individuals plus members of a clinically based pediatric research center, and the Division of Pediatric Pulmonary Medicine, and the Director of the Division of Pediatric Education.
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| Sullivan, Sean D; Weiss, Kevin B; Lynn, Henry et al. (2002) The cost-effectiveness of an inner-city asthma intervention for children. J Allergy Clin Immunol 110:576-81 |
| Mortimer, K M; Neas, L M; Dockery, D W et al. (2002) The effect of air pollution on inner-city children with asthma. Eur Respir J 19:699-705 |
| Mortimer, K M; Redline, S; Kattan, M et al. (2001) Are peak flow and symptom measures good predictors of asthma hospitalizations and unscheduled visits? Pediatr Pulmonol 31:190-7 |
