As part of the breakout session panel discussion entitled  UMass Lowell Gerontology Community-Engaged Research Panel,  Dr. Turcotte discusses his intervention study of environmental asthma triggers for asthmatic older adults in Lowell, Mass

Adejumo, Kelechi

Caraballo, Carla

Chaves, Emily

Gore, Rebecca

Mouth, Ronnie

Turcotte, David

Woskie, Susan

English

eScholarship@UMMS

University of Massachusetts Medical School eScholarship@UMMS Community Engagement and Research Symposia 2014 Community Engagement and Research Symposium Nov 7th, 1:30 PM Healthy Homes for Elders: Multi-trigger, Multi-component Environmental Interventions for Asthma David Turcotte University of Massachusetts Lowell Et al. Let us know how access to this document benefits you. Follow this and additional works at: https://escholarship.umassmed.edu/chr_symposium  Part of the Civic and Community Engagement Commons, Community-Based Research Commons, Community Health and Preventive Medicine Commons, Environmental Public Health Commons, Geriatrics Commons, Gerontology Commons, and the Translational Medical Research Commons Repository Citation Turcotte D, Woskie S, Chaves E, Gore R, Adejumo K, Caraballo C, Mouth R. (2014). Healthy Homes for Elders: Multi-trigger, Multi-component Environmental Interventions for Asthma. Community Engagement and Research Symposia. https://doi.org/10.13028/qj3d-0k45. Retrieved from https://escholarship.umassmed.edu/chr_symposium/2014/program/6 Creative Commons License This work is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 3.0 License. This material is brought to you by eScholarship@UMMS. It has been accepted for inclusion in Community Engagement and Research Symposia by an authorized administrator of eScholarship@UMMS. For more information, please contact Lisa.Palmer@umassmed.edu. Healthy Homes for Elders: Multi-trigger, Multi-component Environmental Interventions for Asthma  David Turcotte, ScD University of Massachusetts Lowell  Susan Woskie, PhD  Emily Chaves, MA  Rebecca Gore, PhD  Kelechi Adejumo, MS    Carla Caraballo  Lowell Community Health Center  Ronnie Mouth Funded by the U.S. Department of Housing and Urban Development   Why asthma? Why Lowell? – High asthma rate – Diverse community – Community health & PHA partners – Novel intervention research with asthmatic seniors Asthma Prevalence Rates in Lowell by Age-Group *Pediatrics Asthma Surveillance, 2008-2009;  **Massachusetts Behavioral Risk Factor Surveillance System, 2011 Prepared 01/13/2014 by Massachusetts Department of Public Health Prevalence in Lowell 95% Cl-Lo 95% CI-Up Children (5-14)* 13.01 12.40 13.63 Adults (18-64)** 15.9 12 19.9 Adults (65+)** 13.6 6.6 20.7 Project Goals:  Home assessments (90)   Home interventions (90) Evaluate home intervention effectiveness Disseminate findings          Partners & Roles • University of Massachusetts Lowell • Lowell Community Health Center • Lowell Housing Authority  Who are we enrolling? • Live in Lowell Public or Assisted Housing • Age 62+ • Current Asthma or  • Asthma Diagnosis & COPD • Low Income What is Asthma? • A serious & sometimes life-threatening respiratory disease • Affects the quality of life for millions of Americans • No cure for Asthma yet • Can be controlled through medical treatment & management of environmental triggers   •Americans spend up to 90% of their time indoors •Indoor concentrations of most pollutants are higher than outdoor Indoor Environment and Asthma Indoor Environment and Asthma • Indoor allergens and irritants can play significant roles in triggering asthma attacks – Ex: pet dander, mice, cockroaches, dust mites, harsh chemicals, fragrances, smoke, moisture/mold, pollen    • Important to recognize potential asthma triggers & reduce exposure  Home Intervention - Assessment • Health/environmental assessments – Health questionnaires  – Urinary cotinine  – eNO (Niox Mino) – Environmental walk-through assessment – Environmental questionnaire – Dust sampling – NO2 sampling (gas stoves)   Assessment Education, Supplies, Remediation Mid-term Assessment 6th month Final Assessment 12th month Education, Supplies, Intervention • Education – Dust mites and healthy cleaning practices – Pets – Avoiding pests – Moisture/mold control – Smoking – Air pollution (indoor & outdoor)  • Supplies – HEPA vacuum – Allergen-proof mattress and pillow covers – Trash can with lid – Food containers – Non-toxic cleaner – Baits and traps for pests  Assessment Education, Supplies, Remediation Mid-term Assessment 6th month Final Assessment 12th month Based on findings from assessment:  Education, Supplies, Remediation Cont. • Remediation – Gas stove replacement – Install & repair ventilation – Integrated Pest Management (IPM) – Industrial cleaning  Assessment Education, Supplies, Remediation Mid-term Assessment 6th month Final Assessment 12th month Mid-term Assessment • Health questionnaire (abbreviated) • Environmental questionnaire (abbreviated) • More supplies if needed • Reinforce education Assessment Education, Supplies, Remediation Mid-term Assessment 6th month Final Assessment 12th month Final Assessment • Health questionnaires • Urinary cotinine  • eNO (Niox Mino) • Environmental questionnaire • Environmental walk-through • Dust sampling • NO2 sampling (gas stoves) • Gift certificate  Assessment Education, Supplies, Remediation Mid-term Assessment 6th month Final Assessment 12th month Results Table 1. Demographics of participants (n=49) Percent (%) Gender: Male 11 22.5 Gender: Female  38 77.5 Race/ethnicity  White/Caucasian 41 83.7 Black/African American 1 2.0 Asian 4 8.2 Native American 1 2.0 Other/Unknown 2 4.1 Hispanic/Latino 27 55.1 Mean Age = 69.4 (n=45) -- -- General Health St. George Respiratory Questionnaire English for the U.S. (n=49) Percent (%) Very Good 2 4.1 Good 10 20.4 Fair 21 42.9 Poor 10 20.4 Very Poor 6 12.2 Respiratory Problems Over Last 3 Months St. George Respiratory Questionnaire English for the U.S. Everyday to several days per week (n=49) Percent (%) Coughed 33 67.3 Brought up phlegm (sputum) 23 46.9 Shortness of breath 34 69.4 Wheezing attacks 17 34.7 Severe respiratory attacks (3+) 12 24.5  Health & Medical Care During Past Year (n=49) Percent (%) Overnight in the hospital 10 20.4 Seen in an emergency room 12 24.5 Emergency visit to doctor/clinic 16 32.6 Treated with antibiotics for a chest illness 15 30.6 Daily medication use for respiratory problems  44  89.8  Environmental Exposures Asthma Triggers (n=46) Percent (%) Air freshener used (1+ days/wk) 35 76.1 Candles/incensed used (1+ days/wk) 5 10.9 Signs of mice (past month)* 6 13 Signs of cockroaches (past month)* 7 15.2 Mold or mildew  7  15.2  Gas Stove (NO & NO2) 29 61.7 *2 household had signs of mice and cockroaches Environmental Exposures Asthma Triggers- Smoking (n=46) Percent (%) Subject smokes 11 23.9 Others in household smoke 0 0 Visitors smoke 6 13 Smoke enters from other apartments/outside 12 26.1 Conclusion • Prevalence of  environmental asthma triggers • Difficulties with exhaled Nitric Oxide (eNO) measurement using Niox Mino device  • Recruitment challenges • Involve key partners to increase impact • Importance of multi-cultural, multilingual lay community health outreach workers     Contact Information David Turcotte, Sc.D. University of Massachusetts Lowell Email: David_Turcotte@uml.edu Telephone: (978) 934-4682   

Healthy Homes for Elders: Multi-trigger, Multi-component Environmental Interventions for Asthma

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Healthy Homes for Elders: Multi-trigger, Multi-component Environmental Interventions for Asthma

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