title: Eastern Carolina Asthma Prevention Program (ECAPP): An Environmental Intervention Study Among Rural and Underserved Children with Asthma in Eastern North Carolina.
abstract: OBJECTIVE
  Asthma is the most common chronic childhood condition affecting 6.3 million (US) children aged less than 18 years. Home-based, multi-component, environmental intervention studies among children with asthma have demonstrated to be effective in reducing asthma symptoms. In this study, a local hospital and university developed an environmental intervention research pilot project, Eastern Carolina Asthma Prevention Program (ECAPP), to evaluate self-reported asthma symptoms, breathing measurements, and number of asthma-related emergency department (ED) visits among low-income, minority children with asthma living in rural, eastern North Carolina. Our goal was to develop a conceptual model and demonstrate any asthma respiratory improvements in children associated with our home-based, environmental intervention.
  
  
  METHODS
  This project used a single cohort, intervention design approach to compare self-reported asthma-related symptoms, breathing tests, and ED visits over a 6 month period between children with asthma in an intervention study group (n = 12) and children with asthma in a control study group (n = 7). The intervention study group received intense asthma education, three home visits, 2 week follow-up telephone calls, and environmental intervention products for reducing asthma triggers in the home. The control group received education at baseline and 2 week calls, but no intervention products.
  
  
  RESULTS
  At the end of the study period, significant improvements were observed in the intervention group compared with the control group. Overall, the intervention group experienced a 58% (46 ± SD 26.9) reduction in self-reported asthma symptoms; 76% (34 ± SD 29.7) decrease in rescue medicine; 12% (145 ± SD 11.3) increase in controller medicine; 37% decrease in mean exhaled nitric oxide levels and 33% fewer ED asthma-related visits.
  
  
  CONCLUSIONS
  As demonstrated, a combination of efforts appeared effective for improving asthma respiratory symptoms among children in the intervention group. ECAPP is a low cost pilot project that could readily be adapted and expanded into other communities throughout eastern North Carolina. Future efforts could include enhanced partnerships between environmental health professionals at local health departments and pediatric asthma programs at hospitals to carry out ECAPP.
authors: Assistant Professor, Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, NC, USA.
authors: Gregory D
authors: GD
authors: Kearney
authors: Pediatric Asthma Coordinator, Vidant Medical Center, Pediatric Asthma Program, Greenville, NC, USA.
authors: Lisa C
authors: LC
authors: Johnson
authors: Assistant Professor, Department of Epidemiology, College of Public Health and Health Professions, College of Medicine, University of Florida, Gainesville, FL, USA.
authors: Xiaohui
authors: X
authors: Xu
authors: Assistant Professor, Department of Health Education and Promotion, College of Health and Human Performance, Environmental Health Sciences Program, East Carolina University, Greenville, NC, USA.
authors: Jo Anne G
authors: JA
authors: Balanay
authors: Research Associate, Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, NC, USA.
authors: Kevin M
authors: KM
authors: Lamm
authors: Research Associate, Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, NC, USA.
authors: Daniel L
authors: DL
authors: Allen
keywords: airway inflammation; environmental health; exhaled nitric oxide