[Show abstract][Hide abstract] ABSTRACT: This article describes the evaluation of a community-based participatory research (CBPR) community health worker (CHW) intervention to improve children's asthma-related health by reducing household environmental triggers for asthma. After randomization to an intervention or control group, 298 households in Detroit, Michigan, with a child, aged 7 to 11, with persistent asthma symptoms participated. The intervention was effective in increasing some of the measures of lung function (daily nadir Forced Expiratory Volume at one second [p = .03] and daily nadir Peak Flow [p = .02]), reducing the frequency of two symptoms ("cough that won't go away," "coughing with exercise"), reducing the proportion of children requiring unscheduled medical visits and reporting inadequate use of asthma controller medication, reducing caregiver report of depressive symptoms, reducing concentrations of dog allergen in the dust, and increasing some behaviors related to reducing indoor environmental triggers. The results suggest a CHW environmental intervention can improve children's asthma-related health, although the pathway for improvement is complex.
[Show abstract][Hide abstract] ABSTRACT: The Community Action Against Asthma combined an intervention study to reduce environmental triggers for childhood asthma at the household and neighborhood level with an epidemiologic study of the relationship between ambient and indoor air quality exposures (e.g., ozone and particulate matter 2.5 and 10) and children's lung function and other asthma-related health indicators. As part of the neighborhood level intervention, activities focused on community organizing and engagement of community groups in education processes around environmental health. For example, CAAA staff worked with a local Detroit school to educate parents on implications of environmental contaminants found at the school and facilitated the creation of an action plan that satisfied parent's concerns. In another example, CAAA community and academic partners shared research results and their implications with local advisory boards for transportation and other projects with environmental health implications. This presentation will describe CAAA's strategy and share accomplishments, challenges and lessons learned through this process.
[Show abstract][Hide abstract] ABSTRACT: There is a need for more guidance on how to implement community-based participatory research, particularly on the roles of community members, throughout the process. This article focuses on how a Steering Committee, composed of representatives from community-based organizations, a local health department, an integrated health care system, and academia from the University of Michigan, participated in the design and implementation of a children's asthma study in Detroit, Michigan: Community Action Against Asthma. In addition, this article focuses on the role of community members as data collectors, examining a variety of sophisticated data collection roles. A description and analysis of how community members shaped and participated in the project, the lessons learned, and recommendations for practitioners are also presented.
Full-text · Article · Aug 2005 · Health Promotion Practice
[Show abstract][Hide abstract] ABSTRACT: The goal of this investigation was to use a community-based participatory research approach to develop, pilot test, and administer an asthma screening questionnaire to identify children with asthma and asthma symptoms in a community setting. This study was conducted as the recruitment effort for Community Action Against Asthma, a randomized trial of a household intervention to reduce exposure to environmental triggers of asthma and was not designed as a classic prevalence study. An asthma screening questionnaire was mailed and/or hand delivered to parents of 9,627 children, aged 5 to 11 years, in two geographic areas of Detroit, Michigan, with predominantly African American and Hispanic populations. Additional questionnaires were distributed via community networking. Measurements included parent report of their child's frequency of respiratory symptoms, presence of physician diagnosis of asthma, and frequency of doctor-prescribed asthma medication usage. Among the 3,067 completed questionnaires, 1,570 (51.2% of returned surveys, 16.3% of eligible population) were consistent with asthma of any severity and 398 (12.9% of returned surveys, 4.1% of eligible population) met criteria for moderate-to-severe asthma. Among those meeting criteria for moderate-to-severe asthma, over 30% had not been diagnosed by a physician, over one half were not taking daily asthma medication, and one quarter had not taken any physician-prescribed asthma medication in the past year. Screening surveys conducted within the context of a community-based participatory research partnership can identify large numbers of children with undiagnosed and/or undertreated moderate-to-severe asthma. These children are likely to benefit from interventions to reduce morbidity and improve quality of life.
Full-text · Article · Oct 2004 · Journal of Urban Health