AQI and Childhood Asthma: an Intervention
AQI and Childhood Asthma: an Intervention
This is a small pilot prospective intervention trial in children with asthma who will be
 randomized to receive either (A) Air Quality Index (AQI) education + an asthma action plan
 (control) or (B) AQI education + an asthma action plan which contains AQI behavioral
 recommendations + demonstrate ability to navigate to AirNow either online or on smartphone
 app (intervention).
Over 3 million US children with asthma reported at least one attack in the prior year. Poorly
 controlled asthma is a major cause of suffering, school absences, loss of caregiver
 productivity, and healthcare costs (estimated as ~$80 billion/year). Over half of children on
 controller medication are not well controlled, due to environmental exposures, non-adherence,
 or true non-response to treatment. Outdoor air pollution is a known trigger of asthma.
 Although sound health policies are the best long-term approaches to reduce the harmful
 effects of air pollution, exposure avoidance is needed until "clean air" is ensured through
 effective legislation. Despite this, healthcare providers infrequently provide pollution
 exposure advice to children with asthma. The Environmental Protection Agency (EPA) monitors
 air pollution and reports a daily Air Quality Index (AQI) that is easy to use and available
 in most metropolitan areas. Practical recommendations regarding outdoor activity can be based
 on AQI levels. Despite this, AQI-based recommendations are rarely addressed in asthma action
 plans (AAP). No pediatric study has assessed the addition of the AQI to AAP to reduce asthma
 morbidity. This proposal seeks to recruit a pilot cohort of 40 children with asthma + 40
 parent/guardian. Using this cohort, the investigators will test the hypotheses that (1) the
 addition of the AQI to AAP will reduce asthma exacerbations and (2) the addition of the AQI
 to AAP will improve asthma symptom control & quality of life in children with asthma. The
 inclusion of the AQI onto asthma action plans is novel in clinical asthma care; its wide
 availability would make large-scale implementation feasible. The investigators expect this
 low-cost and low-tech intervention will have a positive impact in reducing asthma morbidity.
 Given that 1 out of every 12 children in the U.S. has asthma, this is relevant to health care
 professionals, parents, and public health practitioners.

 Optional, the investigators will collect nasal epithelial cells for use in future
 genomic/epigenetic studies.
Inclusion Criteria:

 -  Child Inclusion criteria includes:

 1. physician diagnosis of persistent asthma- either mild, moderate, or severe;

 2. family home internet access and/or smartphone access + willingness to download
 AirNow app on phone;

 3. age 8-17 years.

 Parent/guardian inclusion: parent or guardian of the child participant, of whom has met
 inclusion criteria.

 Exclusion Criteria:

 -  Child exclusion criteria includes:

 1. diagnosis of other chronic respiratory disease (e.g. cystic fibrosis,
 bronchopulmonary dysplasia, etc)

 2. immunodeficiency- acquired or congenital

 3. neuromuscular disease

 4. disability affecting ambulation

 5. cyanotic congenital heart disease

 6. only 1 child per household eligible

 7. no plans to leave Pittsburgh area in next 6 months

 Parental/guardian exclusion criteria: none.