University of Oklahoma Health Sciences Center

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Author/s:

Rosser, F. J., Rothenberger, S. D., Han, Y., Forno, E., Celedón, J. C.

Date Added:

January 18, 2023

Journal/Publication:

American Journal of Preventative Medicine

Publisher:

Elsevier

Publication Date:

January 13, 2023

Pages:

1-5

URL:

Air Quality Index and Childhood Asthma: A Pilot Randomized Clinical Trial Intervention

Type:

Clinical Research Results

Format:

Article

DOI (1):

10.1016/j.amepre.2022.12.010

PMID (1):

36642643

Keywords

children

quality of life

asthma

air pollution

United States

MeSH

air pollution

Surveys and Questionnaires

child

random allocation

asthma

RPR Commentary

Adding instructions regarding use of the Air Quality Index to asthma action plans improved asthma control in children. James W. Mold, MD, MPH

Abstract

Introduction: To reduce air pollution exposure, the U.S. asthma guidelines recommend that children check the Air Quality Index before outdoor activity. Whether adding the Air Quality Index and recommendations to asthma action plans reduces exacerbations and improves control and quality of life in children with asthma is unknown.

Methods: A pilot, unblinded, randomized clinical trial of 40 children with persistent asthma, stratified by age and randomized 1:1, recruited from the University of Pittsburgh Medical Center Children's Hospital of Pittsburgh (Pittsburgh, PA) was conducted. All participants received asthma action plans and Air Quality Index education. The intervention group received printed Air Quality Index information and showed the ability to use AirNow. Asthma exacerbations were assessed through a questionnaire, asthma control was assessed with the Asthma Control Test and Childhood Asthma Control Test, and quality of life was assessed with the Pediatric Asthma Quality of Life Questionnaire. After randomization (July-October 2020), participants were followed monthly for 6 months (exit January-March 2021). Outcome differences between groups were evaluated at the exit visit and over time (analysis was in 2021).

Results: At randomization, there were no significant differences in age, sex, race, or asthma severity. At exit, more intervention participants checked the Air Quality Index (63% vs 15%) with no differences in the proportion of asthma exacerbations or mean Childhood Asthma Control Test or Pediatric Asthma Quality of Life Questionnaire scores. The mean change in Asthma Control Test score was higher in the intervention group (change in Asthma Control Test=2.00 vs 0.15 for the control), which was modified by time (β=1.85, CI=0.09, 3.61). Physical activity was decreased overall and showed modification by treatment and time.

Conclusions: Addition of the Air Quality Index to asthma action plans led to improved asthma control by Asthma Control Test scores but may decrease outdoor activity.

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