The Environmental Health Service at Baylor College of Medicine is the recipient of a grant from the Patient-Centered Outcomes Research Institute (PCORI) that will provide more than $2 million over three years to test the effectiveness of a home-based environmental intervention program to improve asthma control and quality of life among African-American adults in the Houston area.

Baylor’s research project is one of 82 proposals approved for funding to advance the field of patient-centered comparative effectiveness research and provide patients with information that will help them make better-informed decisions about their care. Dr. Winifred Hamilton, assistant professor of medicine at Baylor, will serve as principal investigator of the study.

“Asthma imposes a disproportionate burden on the area’s African-American population, and environmental factors play an important role. This effort is noteworthy because it has the capacity—through extensive use of electronic medical records and close collaboration with the Harris Health System—to reach a large number of African-American adults with poorly controlled asthma, a group with especially high rates of emergency department utilization, hospitalizations and mortality risk,” said Hamilton.

Reducing exposure

Research shows that reducing exposure to environmental hazards—such as dust mites, mold, volatile organic compounds, combustion gases, particulates and cigarette smoke—can significantly reduce the morbidity associated with a number of cardiorespiratory conditions, especially asthma. A comprehensive home-visit strategy that includes an environmental component focused on reducing key exposures as well as customized self-management education and support can markedly decrease symptoms and improve quality of life.

Baylor’s home-visit team will conduct an assessment, communicate the results of the assessment and then phase in implementation of a customized action plan, with ongoing patient-centered communication, monitoring and reinforcement. The action plan includes specific exposure reduction protocols such as allergen-proof bedding covers, integrated pest management and moisture control, help with medical compliance and assistance with related issues interfering with asthma control, such as mental health issues.

The project also involves Baylor researchers from the section of pulmonary, critical care and sleep medicine as well as the Department of Family and Community Medicine. Other key partners include the Houston Department of Health and Human Services, Prairie View A&M University and The University of Texas MD Anderson Cancer Center (Department of Health Disparities Research).

Baylor College of Medicine’s study and the other projects approved for funding by PCORI’s Board of Governors were selected from 624 applications submitted to PCORI's funding announcements. All were selected through a highly competitive review process in which patients, caregivers and other stakeholders joined scientists to evaluate the proposals. Applications were assessed for scientific merit, how well they will engage patients and other stakeholders, and their methodological rigor among other criteria.

For more information about the study, contact Dr. Rebecca Jensen Bruhl at (713) 798-1078.