Publications by authors named "Ernestine Smartt"
Background: The Urban Environment and Childhood Asthma (URECA) study is a multicenter prospective birth cohort study designed to examine factors related to the development of childhood asthma and allergies in an inner-city population. The retention of these participants has been challenging due to high mobility, inconsistent phone service, custody issues, and stressful life situations.
Purpose: In this article, we describe the specific retention challenges we encountered during the first 2 years of follow-up in URECA and the strategies we utilized to address them.
Background: Although sensitization to fungal allergens is prevalent in inner-city children with asthma, the relationship between fungal exposure and morbidity is poorly understood.
Objective: We examined relationships between fungal sensitization, exposure, and asthma morbidity in inner-city children.
Methods: Participants were 5 to 11 years old and enrolled in the Inner-City Asthma Study.
Background: With the expanding effort to provide guidelines-based therapy to adolescents with asthma, attention must be directed to evaluating which factors predict future asthma control when guidelines-based management is applied.
Objective: We evaluated the role of fraction of exhaled nitric oxide in parts per billion, markers of allergic sensitization, airway inflammation, and measures of asthma severity in determining future risk of asthma symptoms and exacerbations in adolescents and young adults participating in the Asthma Control Evaluation study.
Methods: Five hundred forty-six inner-city residents, ages 12 through 20 years, with persistent asthma were extensively evaluated at study entry for predictors of future symptoms and exacerbations over the subsequent 46 weeks, during which guidelines-based, optimal asthma management was offered.
Context: Barriers impede translating recommendations for asthma treatment into practice, particularly in inner cities where asthma morbidity is highest.
Methods: The purpose of this study was to test the effectiveness of timely patient feedback in the form of a letter providing recent patient-specific symptoms, medication, and health service use combined with guideline-based recommendations for changes in therapy on improving the quality of asthma care by inner-city primary care providers and on resultant asthma morbidity. This was a randomized, controlled clinical trial in 5- to 11-year-old children (n = 937) with moderate to severe asthma receiving health care in hospital- and community-based clinics and private practices in 7 inner-city urban areas.
Background: Asthma-associated morbidity is rising, especially in inner city children.
Objective: We evaluated the allergen sensitivities, allergen exposures, and associated morbidity for participants in the Inner City Asthma Study. We also determined geographic variations of indoor allergen levels.
Background: Despite growing evidence of the importance of exposure to fungi as an environmental risk factor for asthma, few data have been reported on the exposure to airborne fungi of asthmatic children living in US inner cities.
Objective: We sought to examine the spectrum and concentration of fungi in the air inside and outside of the homes of mold-sensitive children with asthma living in US cities. We also analyzed the relationship of the concentration of fungi in indoor air to home characteristics.
Article Synopsis
- - This study focused on children aged 5 to 11 with asthma living in urban areas, who often face high exposure to indoor allergens and tobacco smoke at home.
- - A year-long environmental intervention was tested to reduce these triggers and involved education and remediation strategies tailored to each child’s specific allergens and risks.
- - Results showed that children in the intervention group experienced fewer asthma symptoms and lower allergen levels at home, leading to significant decreases in asthma-related complications compared to a control group.