scholarly journals Randomized Trial of a Portable HEPA Air Cleaner Intervention to Reduce Asthma Morbidity among Latino Children in an Agricultural Community

2021 ◽  
Author(s):  
Rebecca Drieling ◽  
Paul D. Sampson ◽  
Jennifer E. Krenz ◽  
Maria I. Tchong French ◽  
Karen L. Jansen ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Intervention Group ◽  
Living Room ◽  
Asthma Education ◽  
Asthma Morbidity ◽  
Asthma Symptoms ◽  
Clinical Utilization ◽  
Air Cleaners ◽  
Act Score

Abstract BackgroundData on pediatric asthma morbidity and effective environmental interventions in agricultural settings are few.ObjectivesTo evaluate the effectiveness of HEPA air cleaners on asthma morbidity among a cohort of rural Latino children.MethodsSeventy-five children with poorly controlled asthma and residing in non-smoking homes were randomly assigned to asthma education alone or along with HEPA air cleaners placed in their sleeping area and home living room. Asthma Control Test (ACT) score, asthma symptoms in prior two weeks, unplanned clinical utilization for asthma, creatinine-adjusted urinary leukotriene E4 (uLTE4 [ng/mg]), and other secondary asthma outcomes were assessed at baseline, six and 12 months later. Multivariable-adjusted generalized estimating equations examined differences between groups based on repeated measures. Incident rate ratios of ever experiencing the metrics of poorer asthma health during follow-up (suboptimal asthma management) were estimated using Poisson regression models.ResultsMean intervention group child age was 9.2 years, control mean age was 8.6, and two-thirds of participants were male. In repeated measures analysis, intervention participants were less likely to have an ACT score representing poorly controlled asthma (IRR: 0.45 [95% CI: 0.21–0.97]). In Poisson models, intervention participants had reduced risk of ever experiencing an ACT score representing poorly controlled asthma (IRR: 0.43 [95% CI: 0.21–0.89]), ever having any asthma symptoms in the past two weeks (IRR: 0.71 [95% CI: 0.52–0.98]), and lower risk of any unplanned clinical utilization over the year of follow-up (IRR: 0.35 [95% CI: 0.13–0.94]) compared to control participants. There was a suggestion of greater decrease in uLTE4 (ng/mg creatinine) levels among intervention participants (-10% [95% CI: -20% -1%]).DiscussionHEPA air cleaners may provide additional benefit for child asthma health even in settings with strong asthma education programs and in areas where traditional asthmagens (traffic, tobacco smoke) are not prominent factors.Trial RegistrationClinicalTrials.gov Identifier: NCT04919915. Date of retrospective registration: May 19, 2021.

scholarly journals Randomized trial of a portable HEPA air cleaner intervention to reduce asthma morbidity among Latino children in an agricultural community

2022 ◽  
Vol 21 (1) ◽  
Author(s):  
Rebecca L. Drieling ◽  
Paul D. Sampson ◽  
Jennifer E. Krenz ◽  
Maria I. Tchong French ◽  
Karen L. Jansen ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Secondary Analysis ◽  
Living Room ◽  
Latino Children ◽  
Asthma Morbidity ◽  
Link Type ◽  
Clinical Utilization ◽  
Air Cleaner ◽  
Air Cleaners ◽  
Act Score

Abstract Background Data on pediatric asthma morbidity and effective environmental interventions in U.S. agricultural settings are few. We evaluated the effectiveness of HEPA air cleaners on asthma morbidity among a cohort of rural Latino children. Methods Seventy-five children with poorly controlled asthma and living in non-smoking homes were randomly assigned to asthma education alone or along with HEPA air cleaners placed in their sleeping area and home living room. The Asthma Control Test (ACT) score, asthma symptoms in prior 2 weeks, unplanned clinical utilization, creatinine-adjusted urinary leukotriene E4 (uLTE4 [ng/mg]), and additional secondary outcomes were evaluated at baseline, six, and 12 months. Group differences were assessed using multivariable-adjusted generalized estimating equations. Incident rate ratios of ever experiencing the metrics of poorer asthma health during follow-up (suboptimal asthma management) were estimated using Poisson regression models in secondary analysis. Results Mean child age was 9.2 and 8.6 years in intervention and control groups, respectively, and two-thirds of participants were male. Primary analysis of repeated measures of ACT score did not differ between groups (HEPA group mean change compared to controls 10% [95% CI: − 12-39%]). A suggestion of greater decrease in uLTE4 (ng/mg creatinine) was observed (− 10% [95% CI: − 20 -1%]). Secondary analysis showed children with HEPAs were less likely to have an ACT score meeting a clinically defined cutoff for poorly controlled asthma using repeated measures (IRR: 0.45 [95% CI: 0.21–0.97]). In Poisson models, intervention participants had reduced risk of ever meeting this cutoff (IRR: 0.43 [95% CI: 0.21–0.89]), ever having symptoms in the past 2 weeks (IRR: 0.71 [95% CI: 0.52–0.98]), and lower risk of any unplanned clinical utilization (IRR: 0.35 [95% CI: 0.13–0.94]) compared to control participants. Discussion The HAPI study showed generally improved outcomes among children in the HEPA air cleaner group. However, primary analyses did not meet statistical significance and many outcomes were subjective (self-report) in this unblinded study, so findings must be interpreted cautiously. HEPA air cleaners may provide additional benefit for child asthma health where traditional asthmagens (traffic, tobacco smoke) are not prominent factors, but larger studies with more statistical power and blinded designs are needed. Trial registration ClinicalTrials.gov Identifier: NCT04919915. Date of retrospective registration: May 19, 2021.

scholarly journals A Children’s Asthma Education Program: Roaring Adventures of Puff (RAP), Improves Quality of Life

2010 ◽  
Vol 17 (2) ◽  
pp. 67-73 ◽  
Author(s):  
Shawna L McGhan ◽  
Eric Wong ◽  
Heather M Sharpe ◽  
Patrick A Hessel ◽  
Puish Mandhane ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Usual Care ◽  
Education Program ◽  
Intervention Group ◽  
Asthma Management ◽  
Control Group ◽  
Asthma Education ◽  
Children With Asthma

BACKGROUND: It is postulated that children with asthma who receive an interactive, comprehensive education program would improve their quality of life, asthma management and asthma control compared with children receiving usual care.OBJECTIVE: To assess the feasibility and impact of ‘Roaring Adventures of Puff’ (RAP), a six-week childhood asthma education program administered by health professionals in schools.METHODS: Thirty-four schools from three health regions in Alberta were randomly assigned to receive either the RAP asthma program (intervention group) or usual care (control group). Baseline measurements from parent and child were taken before the intervention, and at six and 12 months.RESULTS: The intervention group had more smoke exposure at baseline. Participants lost to follow-up had more asthma symptoms. Improvements were significantly greater in the RAP intervention group from baseline to six months than in the control group in terms of parent’s perceived understanding and ability to cope with and control asthma, and overall quality of life (P<0.05). On follow-up, doctor visits were reduced in the control group.CONCLUSION: A multilevel, comprehensive, school-based asthma program is feasible, and modestly improved asthma management and quality of life outcomes. An interactive group education program offered to children with asthma at their school has merit as a practical, cost-effective, peer-supportive approach to improve health outcomes.

scholarly journals A Brief Body-Mind-Spirit Group Therapy for Chinese Medicine Stagnation Syndrome: A Randomized Controlled Trial

2018 ◽  
Vol 2018 ◽  
pp. 1-12 ◽  
Author(s):  
Siu-man Ng ◽  
Lingli Leng ◽  
Rainbow T. H. Ho ◽  
Zhangjin Zhang ◽  
Qi Wang
Keyword(s):  
Group Therapy ◽  
Effect Size ◽  
Repeated Measures ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Randomized Controlled ◽  
Eta Squared ◽  
Physical Distress

Background. Stagnation syndrome, a diagnostic entity in traditional Chinese medicine (TCM), is characterized by mind-body obstruction-like symptoms. Although TCM has long-established symptom-relief treatments, a comprehensive mind-body intervention was called for. Purpose. The study evaluated the efficacy of a six-session body-mind-spirit (BMS) group therapy for persons with stagnation syndrome. Method. A 2-arm randomized controlled trial design was adopted. The control group received a parallel general TCM instruction course. Both groups completed a pretest (T0), posttest (T1), and 2-month follow-up assessment (T2). The measures included self-report scales on stagnation, depression, anxiety, physical distress, daily functioning, and positive and negative affect; the other measure was of salivary cortisol, a biological marker of stress. Results. Data on 111 adults with stagnation syndrome were included in the analysis. Completion rates were high (over 87%) for both the intervention and control groups. Repeated-measures multivariate MANOVA revealed a significant combined effect with large effect size (eta-squared = 0.42). Repeated-measures ANOVA further revealed that the intervention group showed significant improvements in stagnation, the primary outcome, with medium effect size (eta-squared = 0.11). The intervention group also showed significant improvements in depression, physical distress, everyday functioning, and negative affect (eta-squared = 0.06 to 0.13). Post hoc analysis revealed that the intervention group showed significant improvements over the control group in cortisol level at 2-month follow-up assessment (T0 versus T2) with small effect size (eta-squared = 0.05), but not at posttest (T0 versus T1). Conclusions. Overall, the findings indicate that our brief BMS group therapy intervention for stagnation syndrome is efficacious. Moreover, the intervention resulted in a number of substantial improvements in the physical and mental health domains.

scholarly journals Few Associations Found between Mold and Other Allergen Concentrations in the Home versus Skin Sensitivity from Children with Asthma after Hurricane Katrina in the Head-Off Environmental Asthma in Louisiana Study

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
L. F. Grimsley ◽  
J. Wildfire ◽  
M. Lichtveld ◽  
S. Kennedy ◽  
J. M. El-Dahr ◽  
...  
Keyword(s):  
Hurricane Katrina ◽  
Skin Test ◽  
Skin Sensitivity ◽  
Asthma Morbidity ◽  
Asthma Symptoms ◽  
Children With Asthma ◽  
Allergen Concentration ◽  
Mold Spore ◽  
The City

Mold and other allergen exposures exacerbate asthma symptoms in sensitized individuals. We evaluated allergen concentrations, skin test sensitivities, and asthma morbidity for 182 children, aged 4–12 years, with moderate to severe asthma, enrolled 18 months after Katrina, from the city of New Orleans and the surrounding parishes that were impacted by the storm, into the Head-off Environmental Asthma in Louisiana (HEAL) observational study. Dust (indoor) and air (indoor and outdoor) samples were collected at baseline of 6 and 12 months. Dust samples were evaluated for dust mite, cockroach, mouse, andAlternariaby immunoassay. Air samples were evaluated for airborne mold spore concentrations. Overall, 89% of the children tested positive to ≥1 indoor allergen, with allergen-specific sensitivities ranging from 18% to 67%. Allergen concentration was associated with skin sensitivity for 1 of 10 environmental triggers analyzed (cat). Asthma symptom days did not differ with skin test sensitivity, and surprisingly, increased symptoms were observed in children whose baseline indoor airborne mold concentrations were below median levels. This association was not observed in follow-up assessments. The lack of relationship among allergen levels (including mold), sensitivities, and asthma symptoms points to the complexity of attempting to assess these associations during rapidly changing social and environmental conditions.

scholarly journals Destress 9-1-1—an online mindfulness-based intervention in reducing stress among emergency medical dispatchers: a randomised controlled trial

2019 ◽  
Vol 76 (10) ◽  
pp. 705-711 ◽  
Author(s):  
Michelle Lilly ◽  
Rebecca Calhoun ◽  
Ian Painter ◽  
Randal Beaton ◽  
Scott Stangenes ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Controlled Trial ◽  
Intervention Group ◽  
Future Research ◽  
Control Group ◽  
Post Intervention ◽  
Work Related ◽  
Emergency Medical ◽  
Emergency Medical Dispatchers

ObjectivesEmergency medical dispatchers (EMDs) experience significant stress in the workplace. Yet, interventions aimed at reducing work-related stress are difficult to implement due to the logistic challenges associated with the relatively unique EMD work environment. This investigation tested the efficacy of a 7-week online mindfulness-based intervention (MBI) tailored to the EMD workforce.MethodsActive-duty EMDs from the USA and Canada (n=323) were randomly assigned to an intervention or wait list control condition. Participants completed surveys of stress and mindfulness at baseline, post intervention, and 3 months follow-up. Repeated measures mixed effects models were used to assess changes in stress and mindfulness.ResultsDifferences between the intervention group and control group in pre–post changes in stress using the Calgary Symptoms of Stress Inventory were statistically significant, with a difference of −10.0 (95% CI: −14.9, −5.2, p<0.001) for change from baseline to post intervention, and a difference of −6.5 (95% CI: −11.9, −1.1, p=0.02) for change from baseline to 3 months follow-up. Change in mindfulness scores did not differ between groups. However, increases in mindfulness scores were correlated with greater reductions in stress for all participants, regardless of group (r=−0.53, p<0.001).ConclusionsDevelopment of tailored online MBIs for employees working in challenging work environments offer a promising direction for prevention and intervention. This study found that a short, weekly online MBI for EMDs resulted in reductions in reports of stress. Implications of online MBIs in other emergency responding populations and directions for future research are discussed.

scholarly journals A New Mental Health Mobile App for Well-Being and Stress Reduction in Working Women: Randomized Controlled Trial

10.2196/14269 ◽  
2019 ◽  
Vol 21 (11) ◽  
pp. e14269 ◽  
Author(s):  
Cássia Canha Coelhoso ◽  
Patricia Renovato Tobo ◽  
Shirley Silva Lacerda ◽  
Alex Heitor Lima ◽  
Carla Regina Camara Barrichello ◽  
...  
Keyword(s):  
Mental Health ◽  
Repeated Measures ◽  
Intervention Group ◽  
Working Women ◽  
Well Being ◽  
Mobile App ◽  
World Health ◽  
Control Group ◽  
Work Related

Background Although the availability and use of mobile mental health apps has grown exponentially in recent years, little data are available regarding their efficacy. Objective This study aimed to evaluate the effectiveness of an app developed to promote stress management and well-being among working women compared with a control app. Methods Female employees at a private hospital were invited to participate in the study via mailing lists and intranet ads. A total of 653 individuals self-enrolled through the website. Eligible participants were randomized between control (n=240) and intervention (n=250) groups. The well-being mobile app provides an 8-week program with 4 classes per week (including a brief theoretical portion and a 15-min guided practice). The active control app also provided 4 assessments per week that encouraged participants to self-observe how they were feeling for 20 min. We also used the app to conduct Web-based questionnaires (10-item Perceived Stress Scale and 5-item World Health Organization Well-Being Index) and ask specific questions to assess subjective levels of stress and well-being at baseline (t1), midintervention (t4=4 weeks after t1) and postintervention (t8=8 weeks after t1). Both apps were fully automated without any human involvement. Outcomes from the control and intervention conditions at the 3 time points were analyzed using a repeated measures analysis of variance. Results Among the randomized participants (n=490), 185 participants were excluded at the 4-week follow-up and another 79 at the 8-week follow-up because of noncompliance with the experimental protocol. Participants who did not complete t4 and t8 assessments were equally distributed between groups (t4: control group=34.6% [83/240] and intervention group=40.8% [102/250]; P=.16; t8: control group=29.9% [47/157] and intervention group=21.6% [32/148]; P=.10). Both groups showed a significant increase in general well-being as a function of time (F2,426=5.27; P=.006), but only the intervention group presented a significant increase in work-related well-being (F2,426=8.92; P<.001), as well as a significant reduction in work-related and overall stress (F2,426=5.50; P=.004 and F2,426=8.59; P<.001, respectively). Conclusions The well-being mobile app was effective in reducing employee stress and improving well-being. Trial Registration Clinicaltrials.gov NCT02637414; https://clinicaltrials.gov/ct2/show/NCT02637414.

Effectiveness of a Mindfulness-Based Retreat on Distress and Well-Being in Bereaved Parents

2020 ◽  
Vol 30 (7) ◽  
pp. 770-782
Author(s):  
Kara Thieleman ◽  
Joanne Cacciatore
Keyword(s):  
Repeated Measures ◽  
Mixed Model ◽  
Intervention Group ◽  
Well Being ◽  
Group Differences ◽  
Significant Group ◽  
Self Compassion ◽  
Bereaved Parents ◽  
Quasi Experimental

Purpose: This study evaluated the effectiveness of a grief-focused mindfulness-based retreat on psychological distress (trauma, anxiety, and depression) and well-being (mindfulness and self-compassion) in bereaved parents. Method: A quasi-experimental design with two nonequivalent groups (intervention, comparison) and three observations was used. Results: Mixed-model repeated-measures analysis of variance showed significant reductions in distress at posttest in the intervention group, with significant group differences on four of the seven scales. While reductions were maintained at follow-up, group differences were only significant for one trauma subscale. The intervention group showed significant increases in two of the four mindfulness facets (describe and act with awareness) and self-compassion at posttest, although group differences were not significant and gains were not maintained at follow-up. A third mindfulness facet, nonjudge, increased significantly at follow-up, with significant group differences. Discussion: This approach shows promise for reducing some areas of distress and improving the nonjudging mindfulness facet in bereaved parents.

Randomized Trial Investigating of a Single-Session Character-Strength-Based Cognitive Intervention on Freshman’s Adaptability

2017 ◽  
Vol 29 (1) ◽  
pp. 82-92 ◽  
Author(s):  
Wenjie Duan ◽  
He Bu
Keyword(s):  
Randomized Trial ◽  
Repeated Measures ◽  
Intervention Group ◽  
Well Being ◽  
Cognitive Intervention ◽  
Control Group ◽  
Single Session ◽  
Character Strength ◽  
Strength Based

Purpose: To investigate the efficiency of a single-session character-strength-based cognitive intervention on enhancing freshmen’s adaptability. Method: A randomized trial, pretest, posttest, follow-up intervention was employed using repeated-measures analyses to evaluate the effect. This 90-min intervention contained four activities with 52 undergraduate freshmen (age 17–20) randomly assigned to the intervention and control group, 38 of whom completed all the programs (19 of each group). Results: Compared with the control group, the intervention group showed a remarkable increase in well-being and a significant reduction in depression and anxiety at post and follow-up assessment. The stress level of the intervention group significantly decreased only at the follow-up test. Time effect and the interaction between time and group were significant in anxiety and stress. Conclusions: This intervention can quickly reduce negative affect and elevate well-being for freshmen. It expands the role of social worker in the prevention of mental illness among college population.

scholarly journals A New Mental Health Mobile App for Well-Being and Stress Reduction in Working Women: Randomized Controlled Trial (Preprint)

2019 ◽  
Author(s):  
Cássia Canha Coelhoso ◽  
Patricia Renovato Tobo ◽  
Shirley Silva Lacerda ◽  
Alex Heitor Lima ◽  
Carla Regina Camara Barrichello ◽  
...  
Keyword(s):  
Mental Health ◽  
Repeated Measures ◽  
Intervention Group ◽  
Working Women ◽  
Well Being ◽  
Mobile App ◽  
World Health ◽  
Control Group ◽  
Work Related

BACKGROUND Although the availability and use of mobile mental health apps has grown exponentially in recent years, little data are available regarding their efficacy. OBJECTIVE This study aimed to evaluate the effectiveness of an app developed to promote stress management and well-being among working women compared with a control app. METHODS Female employees at a private hospital were invited to participate in the study via mailing lists and intranet ads. A total of 653 individuals self-enrolled through the website. Eligible participants were randomized between control (n=240) and intervention (n=250) groups. The well-being mobile app provides an 8-week program with 4 classes per week (including a brief theoretical portion and a 15-min guided practice). The active control app also provided 4 assessments per week that encouraged participants to self-observe how they were feeling for 20 min. We also used the app to conduct Web-based questionnaires (10-item Perceived Stress Scale and 5-item World Health Organization Well-Being Index) and ask specific questions to assess subjective levels of stress and well-being at baseline (<italic>t</italic><sub>1</sub>), midintervention (<italic>t</italic><sub>4</sub>=4 weeks after <italic>t</italic><sub>1</sub>) and postintervention (<italic>t</italic><sub>8</sub>=8 weeks after <italic>t</italic><sub>1</sub>). Both apps were fully automated without any human involvement. Outcomes from the control and intervention conditions at the 3 time points were analyzed using a repeated measures analysis of variance. RESULTS Among the randomized participants (n=490), 185 participants were excluded at the 4-week follow-up and another 79 at the 8-week follow-up because of noncompliance with the experimental protocol. Participants who did not complete <italic>t</italic><sub>4</sub> and <italic>t</italic><sub>8</sub> assessments were equally distributed between groups (<italic>t</italic><sub>4</sub>: control group=34.6% [83/240] and intervention group=40.8% [102/250]; <italic>P</italic>=.16; <italic>t</italic><sub>8</sub>: control group=29.9% [47/157] and intervention group=21.6% [32/148]; <italic>P</italic>=.10). Both groups showed a significant increase in general well-being as a function of time (<italic>F</italic><sub>2,426</sub>=5.27; <italic>P</italic>=.006), but only the intervention group presented a significant increase in work-related well-being (<italic>F</italic><sub>2,426</sub>=8.92; <italic>P</italic>&lt;.001), as well as a significant reduction in work-related and overall stress (<italic>F</italic><sub>2,426</sub>=5.50; <italic>P</italic>=.004 and <italic>F</italic><sub>2,426</sub>=8.59; <italic>P</italic>&lt;.001, respectively). CONCLUSIONS The well-being mobile app was effective in reducing employee stress and improving well-being. CLINICALTRIAL Clinicaltrials.gov NCT02637414; https://clinicaltrials.gov/ct2/show/NCT02637414.

Pilot Testing a Digital Career Literacy Training for Vocational Rehabilitation Professionals

2017 ◽  
Vol 61 (4) ◽  
pp. 236-243 ◽  
Author(s):  
Rebecca Goe ◽  
Catherine Ipsen ◽  
Stacey Bliss
Keyword(s):  
Vocational Rehabilitation ◽  
Repeated Measures ◽  
Intervention Group ◽  
Nonparametric Test ◽  
Control Group ◽  
Significant Group ◽  
Rehabilitation Professionals ◽  
Online Tools ◽  
Literacy Training

Digital career literacy encompasses the skills needed to find and maintain employment in the modern job market. Unfortunately, many state vocational rehabilitation (VR) professionals report feeling unprepared to help their consumers with digital career literacy tasks. To address this gap, we developed and tested five training webinars with VR professionals in Montana, Alabama, and Washington. We randomly assigned VR offices to intervention or control group. VR professionals in the intervention group received access to the training webinars. We collected survey data at baseline and 4 months after the intervention’s conclusion ( n = 136). A repeated measures ANOVA showed significant group by factor effects in counselor preparedness to use online tools during the VR process (intervention group: M1 = 24.41, SD1 = 7.62; M2 = 28.76, SD2 = 7.27; control group: M1 = 25.94, SD1 = 8.64; M2 = 27.21, SD2 = 9.14); F(1, 124) = 5.957, p = .016. A McNemar nonparametric test indicated that more VR professionals in the intervention group reported using LinkedIn at the 4-month follow-up, as compared with the control group ( p = .039). There were no significant changes in use of other online tools. This may relate to administrative policies that do not provide clear guidelines for using online tools in the counseling process.

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