Nyenhuis Sharmilee, Cramer Emily, Grande Matthew, Huntington-Moskos Luz, Krueger Kathryn, Bimbi Olivia, Polivka Barbara, Eldeirawi Kamal
Section of Allergy and Immunology, Department of Pediatrics, University of Chicago, Chicago, IL, United States.
Biostatistics & Epidemiology Core, Health Services & Outcomes Research, Children's Mercy Research Institute, Kansas City, MO, United States.
JMIR Res Protoc. 2022 Aug 2;11(8):e39887. doi: 10.2196/39887.
It is estimated that over 60% of adults with asthma have uncontrolled symptoms, representing a substantial health and economic impact. The effects of the home environment and exposure to volatile organic compounds (VOCs) and fine particulate matter (PM) on adults with asthma remain unknown. In addition, methods currently used to assess the home environment do not capture real-time data on potentially modifiable environmental exposures or their effect on asthma symptoms.
The aims of this study are to (1) determine the feasibility and usability of ecological momentary assessment (EMA) to assess self-report residential environmental exposures and asthma symptoms, home monitoring of objective environmental exposures (total VOCs and PM), and lung function in terms of forced expiratory volume in 1 second (FEV%); (2) assess the frequency and level of residential environmental exposures (eg, disinfectants/cleaners, secondhand smoke) via self-reported data and home monitoring objective measures; (3) assess the level of asthma control as indicated by self-reported asthma symptoms and lung function; and (4) explore associations of self-reported and objective measures of residential environmental exposures with self-reported and objective measures of asthma control.
We will recruit 50 adults with asthma who have completed our online Global COVID-19 Asthma Study, indicated willingness to be contacted for future studies, reported high use of disinfectant/cleaning products, and have asthma that is not well controlled. Participants will receive an indoor air quality monitor and a home spirometer to measure VOCs, PM, and FEV%, respectively. EMA data will be collected using a personal smartphone and EMA software platform. Participants will be sent scheduled and random EMA notifications to assess asthma symptoms, environmental exposures, lung function, and mitigation strategies. After the 14-day data collection period, participants will respond to survey items related to acceptability, appropriateness, and feasibility.
This study was funded in March 2021. We pilot tested our procedures and began recruitment in April 2022. The anticipated completion of the study is 2023.
Findings from this feasibility study will support a powered study to address the impact of home environmental exposures on asthma symptoms and develop tailored, home-based asthma interventions that are responsive to the changing home environment and home routines.
ClinicalTrials.gov NCT05224076; https://clinicaltrials.gov/ct2/show/NCT05224076.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/39887.
据估计，超过60%的成年哮喘患者症状未得到控制，这对健康和经济造成了重大影响。家庭环境以及接触挥发性有机化合物（VOCs）和细颗粒物（PM）对成年哮喘患者的影响尚不清楚。此外，目前用于评估家庭环境的方法无法获取有关潜在可改变的环境暴露及其对哮喘症状影响的实时数据。
本研究的目的是：（1）确定生态瞬时评估（EMA）在评估自我报告的居住环境暴露和哮喘症状、客观环境暴露（总挥发性有机化合物和细颗粒物）的家庭监测以及以1秒用力呼气量（FEV%）衡量的肺功能方面的可行性和可用性；（2）通过自我报告数据和家庭监测客观指标评估居住环境暴露的频率和水平（如消毒剂/清洁剂、二手烟）；（3）根据自我报告的哮喘症状和肺功能评估哮喘控制水平；（4）探索自我报告和客观测量的居住环境暴露与自我报告和客观测量的哮喘控制之间的关联。
我们将招募50名成年哮喘患者，他们已完成我们的在线全球COVID-19哮喘研究，表明愿意被联系参与未来研究，报告大量使用消毒剂/清洁产品，且哮喘控制不佳。参与者将分别获得一台室内空气质量监测仪和一台家用肺活量计，以测量挥发性有机化合物、细颗粒物和1秒用力呼气量。EMA数据将使用个人智能手机和EMA软件平台收集。将向参与者发送定期和随机的EMA通知，以评估哮喘症状、环境暴露、肺功能和缓解策略。在14天的数据收集期结束后，参与者将回答与可接受性、适宜性和可行性相关的调查项目。
本研究于2021年3月获得资助。我们对程序进行了预试验，并于2022年4月开始招募。预计研究于2023年完成。
这项可行性研究的结果将支持一项有足够样本量的研究，以解决家庭环境暴露对哮喘症状的影响，并制定针对不断变化的家庭环境和家庭日常活动的、量身定制的家庭哮喘干预措施。
ClinicalTrials.gov NCT05224076；https://clinicaltrials.gov/ct2/show/NCT05224076。
国际注册报告识别码（IRRID）：DERR1-10.2196/39887。
