DESIGN AND METHODS OF THE NATIONAL COOPERATIVE INNER-CITY ASTHMA STUDY

The National Cooperative Inner-City Asthma Study (NCICAS) was establis hed to identify and then intervene on those factors which are related to asthma morbidity among children in the inner-city. This paper descr ibes the design and methods of the broad-based initial Phase I epidemi ologic investigation. Eight research centers enrolled 1,528 children, 4 to 9 years of age, from English-or Spanish-speaking families, all of whom resided in major metropolitan inner-city areas. The protocol inc luded an eligibility assessment and an extensive baseline visit, durin g which symptom data, such as wheezing, lost sleep, changes in activit ies of daily living, inpatient admissions, and emergency department an d clinic visits were collected. A comprehensive medical history for ea ch child was taken and adherence to the medical regimen was assessed. Access, as well as barriers, to the medical system were addressed by a series of questions including the location, availability, and consist ency of treatment for asthma attacks, follow-up care, and primary care . The psychological health of the caretaker and of the child was also measured. Asthma knowledge of the child and caretaker was determined. Sensitization to allergens was assessed by skin-prick allergen testing and exposure to cigarette smoke and the home environment were assesse d by questionnaire-For more than a third of the families, in-home visi ts were conducted with dust sample allergen collection and documentati on of the home environment, such as the presence of pets and evidence of smoking, mildew, and roaches. Urine specimens were collected to mea sure passive smoke exposure by cotinine assays, blood samples were dra wn for banking, and children age 6 to 9 years were given spirometric l ung function assessment. At 3, 6 and 9 months following the baseline a ssessment, telephone interviews were conducted to ask about the child' s symptoms, unscheduled emergency department or clinic visits, and hos pitalizations. At this time, peak flow measurements with 2-week diary symptom records were collected. (C) 1997 Wiley-Liss, Inc.