Children With Asthma in New Orleans After Hurricane Katrina

This document presents the protocol for conducting the Head-off Environmental Asthma in Louisiana (HEAL) study in New Orleans, Louisiana. The goal of the HEAL study is to implement and test an Asthma Counselor (AC) intervention program that addresses the multidimensional impact of hurricane Katrina on children with asthma in New Orleans. HEAL is a prospective, controlled trial in which children will be randomly assigned to one of two treatment groups. Group 1 children will receive an AC intervention focused on case management, adherence to medications and education on allergen avoidance. The responsibilities of the AC in this study are enhanced relative to previous initiatives such as the National Cooperative Inner City Asthma Study (NCICAS) AC intervention to also provide families with education aimed at reducing mold, allergens, and moisture in their homes, and materials to aid this effort (dehumidifiers and HEPA air filters). Since 90% of children with asthma in New Orleans are sensitive to dust allergens, established allergen control measures will be incorporated into the AC intervention as well. Group 2 children will receive a high quality standard of care based on the National Asthma Education and Prevention Program (NAEPP)-NIH guidelines. An abbreviated AC intervention will be provided to children in Group 2 at the conclusion of the study. Both treatments will be administered over a 12-month period during which the children in both groups will receive an extensive clinical evaluation (at baseline and 12-months) and three environmental home evaluations (focused on moisture, mold and other allergens). In addition to monitoring the effectiveness of the AC at environmental remediation education, the environmental home evaluations will also allow some characterization of the relationships between allergens, post-Katrina environmental exposures and asthma morbidity. In addition to the enhanced AC intervention, a separate school based survey will be administered to a sample population of children to examine asthma prevalence and assess living conditions and stress levels that may have been influenced by hurricane Katrina. The survey population will consist of a sample of the families of Orleans Parish school children stratified by age, schools and geographic area of the Parish. The results of the survey, in combination with the results of the AC intervention, will give us an overview of the extent and severity of the asthma problem in post hurricane Katrina New Orleans. The HEAL project is a collaborative multi-institutional research project conducted by the Tulane University School of Public Health and Tropical Medicine and the New Orleans Department of Health. To support those efforts, Rho, Inc. will provide for coordination of data and study activities.