Imperial County Asthma Comparative Effectiveness Research Project
Asthma is a common health problem in Imperial County, a largely Latino border community in California. It affects 1 in 5 children in Imperial County which is higher than national estimates. Asthma control is influenced by many factors such as how we take care of our health, how we use asthma medication, how we control things in and outside our home that cause asthma (known as environmental triggers), how good the care we receive from a health professional is, and how clean the air we breathe is. These are factors found in family, clinic, and community settings. In this study, we will compare treatments or interventions that help people with asthma in all or some of these settings. We believe that for Latino youth to have better control of their asthma it is necessary to help them in all of these settings but we will only know that if we compare it to other treatments that don't. People with asthma, health professionals, patient dvocates, and researchers in Imperial County all define asthma control in different ways. Because of this, we will interview parents before and after the treatments and define success in three ways:
- if a parent reports that their child, 6-17 years old, has better control of their asthma;
- the parent reports that her/his child has a good or better quality of life; and
- a medical instrument known as a spirometer measures "normal" or better lung functioning in the child with asthma.
This study is a partnership between an academic/research institute (San Diego State University and the Institute for Behavioral and Community Health) with over 30 years of experience conducting rigorous public health research, a community clinic (Clínicas de Salud del Pueblo, Inc.) with excellent reach and credibility in the partner community, a community-based organization (Comité Cívico del Valle) with extensive experience in promoting asthma control, and a division of the state health department (California Breathing) responsible for asthma control efforts statewide. Together, we will determine how well the study was done, if the interventions were successful, and if others will be able to repeat what we did in their communities.
Imperial County Community Air Monitoring Project
An Impacted Community
Imperial County, California, is a primarily Latino county with some of the highest rates of unemployment and poverty in the nation. Along with numerous environmental concerns cited by residents, including water contamination and pesticide use, air pollution is a major concern. For decades, the county has exceeded the state standard for PM10 for periods lasting over six months, and the county consistently has one of the highest asthma hospitalization and emergency room visit rates in the state for school-aged children.
Limited Data for Action
With limited air pollution monitors in a county that spans over 4,000 square miles, the county's air quality monitoring network has limited ability to measure air pollution hotspots of greatest community concern. While Imperial County has a historically active and committed population, this lack of information is an impediment to assessing and informing policies and practices to reduce exposures and improve health.
New Air Monitoring Project in Imperial County
In partnership with Comité Cívico del Valle (CCV), a local community organization and long-time collaborator, along with the University of Washington and other partners, the California Environmental Health Tracking Program (CEHTP) received a grant from the National Institutes of Health to conduct a 4-year community-based air monitoring research project in Imperial County, CA.
The project will engage members from impacted communities to design an Air Quality Monitoring Network (AQMN) and to develop strategies to use data from the network for public health action. A Community Steering Committee will play a key role in project design, implementation, and decision-making. Additional community members will engage in data collection, placing air monitors, results interpretation, and dissemination.
Participants from 10 neighborhoods of concern will define and map local hazards and assets to inform the placement of air monitors for the AQMN, highlight factors contributing to community vulnerability and resilience, and delineate cumulative exposures.
Community-Operated Air Quality Monitoring Network
The AQMN will consist of 40 low-cost, portable air monitors placed throughout Imperial County. The project will use an innovative approach to determine the locations of the monitors, incorporating community-generated data and community input, along with requirements for scientific rigor. Community members will set up and maintain the monitors, which will remain in the community after the project.
Reporting Real-Time Air Monitoring Data
The AQMN will relay data to the internet for immediate information on air pollution levels. The data will be publicly displayed on Imperial Visions Action Network (IVAN) community-based environmental reporting website. Data will also be available on the CEHTP web portal.
Identifying Hot Spots
Project researchers will combine data from the AQMN with data from existing state and federal air monitors to create highly detailed maps of air pollution by location and time. Using advanced analytical methods (such as state-of-the-art dispersion and land use regression modeling), the project will result in the most accurate and detailed picture of air quality (PM10 and PM2.5) throughout the county, enabling identification of hot spots near vulnerable populations.
Translating Research Results into Action
Community participants, the steering committee, and project staff will examine mapping activity results and data from the AQMN to discuss key findings and issues of concern. Together, the group will develop and implement a public health action plan for reducing exposures and improving health. The group will also discuss strategies for sustainability after the project’s completion.
Community Steering Committee Members
|Ray Askins||Community Advocate|
|Ray Askins||Community Advocate|
|Edie Harmon||Community Advocate|
|John Hernandez||Our Roots Multi-Cultural Center|
|Leticia Ibarra||Clínicas de Salud del Pueblo, Inc.|
|Humberto Martinez||Community Advocate|
|Rosie Nava||Family Tree House|
|Anita Nicklen||Community Advocate|
|Frances Nicklen||Community Advocate|
|Emma Rosa Silva||Calexico Housing Authority|
|Elizabeth Swerdfeger||Community Advocate|
|Carolina Villa||Seeley Citizens United|
- California Environmental Health Tracking Program
- Comité Cívico del Valle
- University of Washington with George Washington University
- National Latino Research Center, Cal State San Marcos
- University of California at Berkeley
- Z-Data Solutions
The California Environmental Health Tracking Program is a collaboration of the California Department of Public Health and the Public Health Institute. This project is funded by the NIH National Institute of Environmental Health Sciences, grant number 1R01ES022722-01A1.