title: Does a multifaceted environmental intervention alter the impact of asthma on inner-city children?
abstract: OBJECTIVE
  To evaluate the impact of a multifaceted environmental and educational intervention on the indoor environment and health in 5-12-year-old children with asthma living in urban environments.
  
  
  METHODS
  Changes in indoor allergen levels and asthma severity measurements were compared between children who were randomized to intervention and delayed intervention groups in a 14-month prospective field trial. Intervention group households received dust mite covers, a professional house cleaning, and had roach bait and trays placed in their houses.
  
  
  RESULTS
  Of 981 eligible children, 410 (42%) were enrolled; 161 (40%) completed baseline activities and were randomized: 84 to intervention and 77 to delayed intervention groups. At the study's end, dust mite levels were 163% higher than at baseline for the delayed intervention group. Overall asthma severity scores did not change. However, the median functional severity score (FSS) component of the severity score improved more in the intervention group (33% vs. 20%) than in the delayed intervention group. At the study's end, the median FSSs for the intervention group improved 25% compared with the delayed intervention group, (p<0.01). Differences between groups for medication use, emergency department (ED) visits or hospitalization were not significant.
  
  
  CONCLUSIONS
  Despite low retention, the intervention resulted in decreased dust mite allergen levels and increased FSSs among the intervention group. The interventions probably contributed to the improvements, especially among the more severely affected children. This study highlights the complexities of designing and assessing the outcomes from a multifaceted asthma intervention.
authors.affiliation: National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. sjw9@cdc.gov
authors.forename: Seymour G
authors.initials: SG
authors.lastname: Williams
authors.forename: Clive M
authors.initials: CM
authors.lastname: Brown
authors.forename: Kenneth H
authors.initials: KH
authors.lastname: Falter
authors.forename: Clinton J
authors.initials: CJ
authors.lastname: Alverson
authors.forename: Carol
authors.initials: C
authors.lastname: Gotway-Crawford
authors.forename: David
authors.initials: D
authors.lastname: Homa
authors.forename: Donna S
authors.initials: DS
authors.lastname: Jones
authors.forename: E Kathleen
authors.initials: EK
authors.lastname: Adams
authors.forename: Stephen C
authors.initials: SC
authors.lastname: Redd
mesh_terms: D000485:Allergens; D001249:Asthma / Q000276:immunology / Q000517:prevention & control*; D002648:Child; D002675:Child, Preschool; D003150:Community Health Workers; D004781:Environmental Exposure; D005260:Female; D005845:Georgia; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007073:Immunoglobulin E; D008297:Male; D010353:Patient Education as Topic; D011446:Prospective Studies; D039981:Pyroglyphidae; D011795:Surveys and Questionnaires; D014504:Urban Health
chemical_list: D000485:Allergens; D007073:Immunoglobulin E