Turcotte David A, Woskie Susan, Gore Rebecca, Chaves Emily, Adejumo Kelechi L, You Kim-Judy
Economics Department and Center for Community Research and Engagement, University of Massachusetts Lowell, Mahoney Hall Suite 212, 870 Broadway St., Lowell, MA, 01854, USA.
Public Health Department, University Massachusetts Lowell, One University Avenue, Lowell, MA, 01854, USA.
Asthma Res Pract. 2020 Nov 2;6(1):13. doi: 10.1186/s40733-020-00066-6.
Research has documented that housing conditions can negatively impact the health of residents. Asthma has many known indoor environmental triggers including dust, pests, smoke and mold, as evidenced by the 25 million people in the U.S. population who have asthma. The paper describes a follow-up study involving elder adults with asthma who participated in a multifaceted home educational and environmental intervention shown to produce significant health benefits. On average the time between the end of the prior intervention study and the follow-up was 2.3 years. The objective of this study was to evaluate whether improvements in environmental conditions and health outcomes resulting from the original Older Adult Study (OAS, multifaceted educational and environmental interventions) would be maintained or decline over time for these low income seniors with asthma.
Health assessment included data on respiratory health outcomes included the Saint George's Respiratory Questionnaire (SGRQ) and Asthma Control Test from the original Older Adult Study (OAS) and this follow-up Older Adult Study (OAFS) along with health care utilization data. Environmental assessments included evaluation of asthma trigger activities (ATAs) and exposures before and after the original healthy homes intervention (questionnaire, home survey) and at this follow-up. Assessments were conducted in English, Khmer and Spanish.
At assessment in the Older Adult Follow-up Study (OAFS), the older adults maintained some of the health improvements gained during the OAS when compared to the OAS pre-intervention baseline. However, health outcomes declined from the OAS final assessment to the OAFS (only the SGRQ Impact scores were significantly different).
These findings suggest that further study with a larger population is needed to determine if the significant health outcome improvements from multifaceted home educational and environmental interventions (OAS) could be more strongly maintained by providing additional follow-up "booster" interventions to this older adult population with asthma.
研究表明，居住条件会对居民健康产生负面影响。哮喘有许多已知的室内环境触发因素，包括灰尘、害虫、烟雾和霉菌，美国有2500万人患有哮喘就是明证。本文描述了一项针对患有哮喘的老年人的随访研究，这些老年人参与了一项多方面的家庭健康教育和环境干预，已证明该干预对健康有显著益处。在前一项干预研究结束至随访之间的平均时间为2.3年。本研究的目的是评估，对于这些患有哮喘的低收入老年人，最初的老年人研究（OAS，多方面教育和环境干预）所带来的环境条件改善和健康结果，随着时间推移是会保持还是会下降。
健康评估包括呼吸健康结果数据，其中有来自最初的老年人研究（OAS）和本次随访的老年人研究（OAFS）的圣乔治呼吸问卷（SGRQ）和哮喘控制测试，以及医疗保健利用数据。环境评估包括对哮喘触发活动（ATA）的评估，以及在最初的健康家庭干预之前和之后（通过问卷调查、家庭调查）以及本次随访时的暴露情况评估。评估以英语、高棉语和西班牙语进行。
在老年人随访研究（OAFS）的评估中，与OAS干预前基线相比，老年人保持了在OAS期间获得的一些健康改善。然而，健康结果从OAS最终评估到OAFS有所下降（只有SGRQ影响分数有显著差异）。
这些发现表明，需要对更多人群进行进一步研究，以确定通过对这群患有哮喘的老年人提供额外的随访“强化”干预，多方面的家庭健康教育和环境干预（OAS）所带来的显著健康结果改善是否能得到更有力的维持。
