title: Enhancing ventilation in homes of children with asthma: pragmatic randomised controlled trial.
abstract: BACKGROUND
  Few robust studies have tested whether enhancing housing also improves health.
  
  
  OBJECTIVE
  To evaluate the effectiveness of installing ventilation systems, and central heating where necessary, in the homes of children with moderate or severe asthma.
  
  
  METHODS
  Pragmatic randomised controlled trial (RCT) in homes within Wrexham County Borough, Wales, UK.
  
  
  METHODS
  A pragmatic RCT was carried out, of a tailored package of housing improvements providing adequate ventilation and temperature, following inspection by a housing officer. One hundred and ninety-two children with asthma aged 5 to 14 years, identified from general practice registers, were randomised to receive this package, either immediately or a year after recruitment. At baseline, and after 4 and 12 months, parents reported their child's asthma-specific and generic quality of life, and days off school.
  
  
  RESULTS
  The package improved parent-reported asthma-specific quality of life significantly at both 4 and 12 months. At 12 months, this showed an adjusted mean difference between groups of 7.1 points (95% confidence interval [CI] = 2.8 to 11.4, P= 0.001): a moderate standardised effect size of 0.42. The generic quality-of-life scale showed reported physical problems were significantly reduced at 4 months, but not quite at 12 months, when the mean difference was 4.5 (95% CI = -0.2 to 9.1, P= 0.061). The improvement in psychosocial quality of life at 12 months was not significant, with a mean difference of 2.2 (95% CI = -1.9 to 6.4, P= 0.292). Parent-reported school attendance improved, but not significantly.
  
  
  CONCLUSIONS
  This novel and pragmatic trial, with integrated economic evaluation, found that tailored improvement of the housing of children with moderate to severe asthma significantly increases parent-reported asthma-related quality of life and reduces physical problems. Collaborative housing initiatives have potential to improve health.
authors: Public Health Wales, Wrexham, UK. louise.woodfine@wales.nhs.uk
authors: Louise
authors: L
authors: Woodfine
authors: Richard D
authors: RD
authors: Neal
authors: Nigel
authors: N
authors: Bruce
authors: Rhiannon T
authors: RT
authors: Edwards
authors: Pat
authors: P
authors: Linck
authors: Linda
authors: L
authors: Mullock
authors: Nick
authors: N
authors: Nelhans
authors: Diana
authors: D
authors: Pasterfield
authors: Daphne
authors: D
authors: Russell
authors: Ian
authors: I
authors: Russell
mesh_terms: D000041:Absenteeism; D000293:Adolescent; D001249:Asthma / Q000517:prevention & control*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006304:Health Status; D006361:Heating / Q000592:standards*; D006798:Housing / Q000592:standards*; D006801:Humans; D008297:Male; D011379:Prognosis; D011788:Quality of Life; D011795:Surveys and Questionnaires; D014691:Ventilation / Q000592:standards*; D014852:Wales