Asthma, Environmental Exposure, Home Environment Related Disease
Conditions
Keywords
volatile organic compounds, particulate matter, home air quality, asthma control, ecological momentary assessment, home air quality monitoring, smartphone technology, home spirometry
Brief summary
The purposes of this study are to determine the practicality of using home indoor air quality monitoring and a smartphone app to identify home air quality changes and how these changes affect adults with asthma.
Detailed description
The aims of this feasibility study are: 1) determine the feasibility and usability of: (a) ecological momentary assessment (EMA) to assess self-report residential environmental exposures and asthma symptoms, (b) home monitoring of objective environmental exposures (total volatile organic compounds \[VOCs\], particulates \[PM2.5\]), and lung function (home spirometry); 2a) assess the frequency and degree of residential environmental exposures (e.g., disinfectants/cleaners, second-hand smoke) via (a) self-reported data, and (b) home monitoring objective measures, 2b) assess the level of asthma control as indicated by self-reported asthma symptoms and lung function; and 3) explore associations of self-reported and objective measures of residential environmental exposures with self-reported and objective measures of asthma control. Participants will receive an indoor air quality monitor and a home spirometer to measure VOCs, PM2.5, and forced expiratory volume percent predicted, respectively. EMA 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 acceptability, appropriateness, and feasibility.
Interventions
OTHERHome Air Quality
This study will assess the feasibility and usability of ecological momentary assessment (EMA) to capture the context of real time behaviors and environmental exposures that impact indoor environments. In addition, the study will assess the feasibility and usability of providing participants with a readily available indoor home air quality monitor to continuously capture total volatile organic compounds (VOCs) and particulates (PM2.5).
Sponsors
National Institute of Environmental Health Sciences (NIEHS)
University of Kansas Medical Center
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adults who previously participated in the online Global Covid-19 and Asthma Study, indicated willingness to be contacted for future research, and reported high use of disinfectant/cleaning products since COVID-19 (≥5 per week). * Current Asthma Control Test (ACT) ≤19 * Own a smartphone * Have a Wi-Fi/wireless internet connection in their home.
Exclusion criteria
* Non-US residents * Non-English speaking
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Episodes Per Day | Measured daily for 14 days | Number of episodes per day that the residential VOCs exceeded 333 ppb and/or PM2.5 exceeded 15 mg/m3, as measured by the Awair home air quality monitor |
| Home Spirometry Completed | Assessed daily for 14 days | Number of participants completing daily home spirometry over 14 days. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Integration of Study Components | 14 days | Participants were asked one survey item to assess if the various components of the study were well integrated. Response options ranged from 0=Strongly disagree to 4=Strongly agree. The score was multiplied by 25; scores could range from 0-100. A higher score indicated that the study components were well integrated. |
| Ecological Momentary Assessment (EMA) Surveys | 14 days | Number of participants completing air quality triggered EMA surveys |
Countries
United States
Participant flow
Recruitment details
Participants were recruited from 5/2022 to 2/2023. Eligibility criteria included previous participation in the Global COVID-19 and Asthma Study (GCAS), willingness to be contacted for future research, high use of disinfectant/cleaning products during COVID-19 (≥5 per week), Asthma Control Test score ≤19 or ≥2 asthma exacerbations in the previous 12 months, owned a smartphone, and had Wi-Fi/wireless connection in their home. Non-US residents and non-English speakers were excluded.
Participants by arm
| Arm | Count |
|---|---|
| A Feasibility Study to Capture Residential Environmental Exposures and Asthma Symptoms in Adults We assessed the feasibility and usability of ecological momentary assessment (EMA) to capture the context of real time behaviors and environmental exposures that impact indoor environments. In addition, we assessed the feasibility and usability of providing participants with a readily available indoor air quality monitor (Awair Omni®) to continuously capture total volatile organic compounds (VOCs) and particulates (PM2.5). This design will allowed us to alert participants of high levels and collect real time data on exposures and asthma symptoms. Daily and exposure-related lung function were measured with a low-cost home spirometer. Finally, we examined the effect of residential environmental exposures that may be related to increased time spent at home due to COVID-19 and the associations between these exposures and asthma control. | 64 |
| Total | 64 |
Withdrawals & dropouts
| Period | Reason | FG000 |
|---|---|---|
| Overall Study | Lost to Follow-up | 24 |
Baseline characteristics
| Characteristic | A Feasibility Study to Capture Residential Environmental Exposures and Asthma Symptoms in Adults |
|---|---|
| Age, Categorical <=18 years | 0 Participants |
| Age, Categorical >=65 years | 4 Participants |
| Age, Categorical Between 18 and 65 years | 60 Participants |
| Age, Continuous | 44.7 years STANDARD_DEVIATION 13.6 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 3 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 60 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 1 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 4 Participants |
| Race (NIH/OMB) Asian | 2 Participants |
| Race (NIH/OMB) Black or African American | 10 Participants |
| Race (NIH/OMB) More than one race | 3 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 1 Participants |
| Race (NIH/OMB) White | 44 Participants |
| Region of Enrollment United States | 64 participants |
| Sex: Female, Male Female | 56 Participants |
| Sex: Female, Male Male | 8 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | 0 / 40 |
| other Total, other adverse events | 0 / 40 |
| serious Total, serious adverse events | 0 / 40 |
Outcome results
Primary
Episodes Per Day
Number of episodes per day that the residential VOCs exceeded 333 ppb and/or PM2.5 exceeded 15 mg/m3, as measured by the Awair home air quality monitor
Time frame: Measured daily for 14 days
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| A Feasibility Study to Capture Residential Environmental Exposures and Asthma Symptoms in Adults | Episodes Per Day | 2.22 Episodes per day | Standard Deviation 1.41 |
Primary
Home Spirometry Completed
Number of participants completing daily home spirometry over 14 days.
Time frame: Assessed daily for 14 days
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| A Feasibility Study to Capture Residential Environmental Exposures and Asthma Symptoms in Adults | Home Spirometry Completed | 40 participants |
Secondary
Ecological Momentary Assessment (EMA) Surveys
Number of participants completing air quality triggered EMA surveys
Time frame: 14 days
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| A Feasibility Study to Capture Residential Environmental Exposures and Asthma Symptoms in Adults | Ecological Momentary Assessment (EMA) Surveys | 40 Participants |
Secondary
Integration of Study Components
Participants were asked one survey item to assess if the various components of the study were well integrated. Response options ranged from 0=Strongly disagree to 4=Strongly agree. The score was multiplied by 25; scores could range from 0-100. A higher score indicated that the study components were well integrated.
Time frame: 14 days
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| A Feasibility Study to Capture Residential Environmental Exposures and Asthma Symptoms in Adults | Integration of Study Components | 87.2 score on a scale | Standard Deviation 20.9 |