Parker 2008.
Methods |
Study design: randomized controlled trial Sampling frame: households in southwest or eastside Detroit with children age 7 to 11 with persistent asthma Sampling method: questionnaires mailed to all caregivers of children age 7 to 11 who attended 1 of 44 elementary schools in neighborhoods; for households with more than 1 eligible child, the child with the most severe symptoms was chosen. Participants participating in baseline assessment were randomly assigned to intervention or control group Collection method: asthma screening questionnaire, measurements of lung function Description of the community coalition: partnership with Detroit Community‐Academic Urban Research Center (URC); community‐based participatory research (CBPR) with steering committee composed of representatives of 8 community‐based organizations, a health service agency, a state agency, an academic institution, and community members |
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Participants |
Communities: eastside and southwest Detroit, MI Country: USA Ages included in assessment: children age 7 to 11 (n = 298) Reasons provided for selection of intervention community: high rates of African American and Latino residents; statistics demonstrating high rates of asthma hospitalization, high rates of poverty, pre‐existing efforts to address health concerns, and pre‐existing relationships Intervention community (population size): 165,000 Comparison community (population size): same |
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Interventions |
Name of intervention: Community Action Against Asthma (CAAS) Theory: Empowerment and Social Cognitive Theory Aim: to improve children’s asthma‐related health by reducing household environmental triggers for asthma through activities delivered by community health workers (CHWs) Description of costs and resources: not provided Components of the intervention: community health worker home visits (> 9/y). CHWs provided tailored information, strategies, methods, and materials to reduce environmental triggers, as well as referral to medical treatment and/or other social services (e.g. food bank) (intervention group: n = 162; control group: n = 166) Start date: 2000 Duration: 12 months |
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Outcomes |
Outcomes and measures: lung function (daily nadir forced expiratory volume, daily nadir peak flow), asthma symptoms (cough that will not go away, coughing with exercise), unscheduled medical visits, use of asthma controller medications Time points: 1‐year follow‐up |
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Notes |
Funder: National Institute for Environmental Health Sciences and the US Environmental Protection Agency Funding source: government |
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Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Low risk | Random number generator used for randomization |
Allocation concealment (selection bias) | Unclear risk | Not described |
Baseline outcome measurement similar | High risk | Unscheduled medical care and uncontrolled symptoms higher in intervention group at baseline; P values not provided |
Baseline characteristics similar | Low risk | Intervention and control groups showed no significant differences with regard to baseline characteristics |
Blinding of outcome assessment (detection bias) All outcomes | High risk | No blinding reported |
Incomplete outcome data (attrition bias) All outcomes | Unclear risk | 25% attrition rates did not differ between intervention and control |
Blinding of participants and personnel (performance bias) All outcomes | High risk | No blinding performed |
Protection against contamination | Unclear risk | Cases and controls lived in close geographic proximity and attended the same schools |
Selective reporting (reporting bias) | Low risk | Main outcomes reported |