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 Study (SICAS) is a National Institutes of Health (NIH)-funded prospective study evaluating the school/classroom-specific risk factors and asthma morbidity among urban children. Methods/results. This article 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.

• asthma
• inner-city
• school

Acknowledgments

Supplies were generously donated or discounted; Lincoln Diagnostics, Inc., Decatur, IL, USA, donated Multi-Test II devices; Greer Laboratories, Inc., Lenoir, NC, USA, donated allergenic extracts for skin testing.

Declaration of Interest

This study was supported by grants R01 AI 073964 and R01 AI 073964-02S1 from the National Institutes of Health. All authors do not have any financial and personal relationships with other people or organizations that could influence (bias) their work. We have no disclosures of any affiliation with any organization with a financial interest, direct or indirect, in the subject matter or materials discussed in the manuscript (such as consultancies, employment, paid expert testimony, honoraria, speakers bureaus, retainers, stock options or ownership, patents or patent applications, or travel grants) that may affect the conduct or reporting of the work submitted. This work was conducted with support from Harvard Catalyst | The Harvard Clinical and Translational Science Center (NIH Award #UL1 RR 025758 and financial contributions from Harvard University and its affiliated academic health care centers). The content is solely the responsibility of the authors and does not necessarily represent the official views of Harvard Catalyst, Harvard University and its affiliated academic health care centers, the National Center for Research Resources, or the National Institutes of Health.