The School Inner-City Asthma Study: Design, Methods, and Lessons Learned

Abstract

Background Children spend a significant amount of time in school. Little is known about the role of allergen exposure in school environments and asthma morbidity. Objectives The School Inner-City Asthma (SICAS) is an NIH funded prospective study evaluating the school/classroom specific risk factors and asthma morbidity among urban children Methods/Results This paper describes the design, methods, and important lessons learned from this extensive investigation. A single center is recruiting 500 elementary school aged children, all of whom attend inner-city, metropolitan schools. The primary hypothesis is that exposure to common indoor allergens in the classroom will increase the risk of asthma morbidity in children with asthma, even after controlling for home allergen exposures. The protocol includes screening surveys of entire schools and baseline eligibility assessments obtained in the spring prior to the academic year. Extensive baseline clinical visits are being conducted among eligible children with asthma during the summer prior to the academic school year. Environmental classroom/school assessments including settled dust and air sampling for allergen, mold, air pollution, and inspection data are collected twice during the academic school year and one home dust sample linked to the enrolled student. Clinical outcomes are measured every 3 months during the academic school year. Conclusion The overall goal of SICAS is to complete the first study of its kind to better understand school-specific urban environmental factors on childhood asthma morbidity. We also discuss the unique challenges related to school-based urban research and lessons being learned from recruiting such a cohort.

Lessons learnt on recruitment and fieldwork from a pilot European human biomonitoring survey

“…Phipatanakul et al (2011) and Kimmel et al (2005) emphasized the necessity of improved communication but Adgate et al (2000) were confronted with a lack of interest of the local media in press-releases about a planned survey because the media was only interested in results. Instead, Adgate et al (2000) were more successful in recruiting families by direct contact of potential participants.…”

“…whole schools or classes) is common. Phipatanakul et al (2011) reported in their lessons learnt from the School Inner-City Asthma Study that convincing the schools was a hard job and had to be repeated every time new schools were included in the study. Therefore they concluded that efforts to engage the school staff in support of the survey have to be increased.…”

“…Jacob and Jacob (2012) showed that even school principals could be easily convinced to participate in a survey if monetary incentives (US $10) were provided. Phipatanakul et al (2011) described the value of additional incentives on participation rate of school children. DEMOCOPHES unveiled that in all participating countries the ethics committees allowed to provide incentives as reward for the inconveniences the participants incurred -at least non-monetary incentives.…”

School Endotoxin Exposure and Asthma Morbidity in Inner-city Children

“…Study procedures were as previously described 10 and as depicted in Figure 1 . Screening questionnaires were collected each spring in participating schools to identify eligible children with asthma.…”

Human Biomonitoring Research at De Montfort University: School and University Participants' Recruitment Experience

“…Other studies have undertaken this approach successfully from a recruitment point of view but with challenges particularly related with "convincing" the schools to participate in biomedical research studies [11][12].…”