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Evaluation of Systematic Assessment of Asthma-Like Symptoms and Tobacco Smoke Exposure in Early Childhood by Well-Child Professionals: A Randomised Trial

OBJECTIVES: This study aimed to evaluate the effectiveness of systematic assessment of asthma-like symptoms and environmental tobacco smoke (ETS) exposure during regular preventive well-child visits between age 1 and 4 years by well-child professionals.METHODS: Sixteen well-child centres in Rotterda... Full description

Journal Title: PLoS ONE 2014, Vol.9(3), pp.urn:issn:1932-6203
Main Author: Groen, E.
Other Authors: van der Valk, R.J.P. , Mohangoo, A.D. , van der Wouden, J.C. , Duijts, L. , Jaddoe, V.W. , Hofman, A. , Koning, H.J. , de Jongste, J.C. , Raat, H.
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ID: ISSN: ; ISSN: 1932-6203
Link: https://research.vumc.nl/en/publications/af4d94d5-d894-4495-9756-b5ff4942289c
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title: Evaluation of Systematic Assessment of Asthma-Like Symptoms and Tobacco Smoke Exposure in Early Childhood by Well-Child Professionals: A Randomised Trial
format: Article
creator:
  • Groen, E.
  • van der Valk, R.J.P.
  • Mohangoo, A.D.
  • van der Wouden, J.C.
  • Duijts, L.
  • Jaddoe, V.W.
  • Hofman, A.
  • Koning, H.J.
  • de Jongste, J.C.
  • Raat, H.
subjects:
  • Sciences (General)
ispartof: PLoS ONE, 2014, Vol.9(3), pp.urn:issn:1932-6203
description: OBJECTIVES: This study aimed to evaluate the effectiveness of systematic assessment of asthma-like symptoms and environmental tobacco smoke (ETS) exposure during regular preventive well-child visits between age 1 and 4 years by well-child professionals.METHODS: Sixteen well-child centres in Rotterdam, the Netherlands, were randomised into 8 centres where the brief assessment form regarding asthma-like symptoms and ETS exposure was used and 8 centres that applied usual care. 3596 and 4179 children (born between April 2002 and January 2006) and their parents visited the intervention and control centres, respectively. At child's age 6 years, physician-diagnosed asthma ever, wheezing, fractional exhaled nitric oxide (FeNO), airway resistance (Rint), health-related quality of life (HRQOL) and ETS exposure at home ever were measured. Linear mixed models were applied.RESULTS: No differences in asthma, wheezing, FeNO, Rint or HRQOL measurements between intervention and control group were found using multilevel regression in an intention-to-treat analysis (p>0.05). Children of whom the parents were interviewed by using the brief assessment form at the intervention well-child centres had a decreased risk on ETS exposure at home ever, compared to children who visited the control well-child centres, in an explorative per-protocol analysis (aOR = 0.71, 95% CI:0.59-0.87).CONCLUSIONS: Systematic assessment and counselling of asthma-like symptoms and ETS exposure in early childhood by well-child care professionals using a brief assessment form was not effective in reducing the prevalence of physician-diagnosed asthma ever and wheezing, and did not improve FeNO, Rint or HRQOL at age 6 years. Our results hold some promise for interviewing parents and using information leaflets at well-child centres to reduce ETS exposure at home in preschool children.TRIAL REGISTRATION: Controlled-Trials.com ISRCTN15790308.
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identifier: ISSN: ; ISSN: 1932-6203
fulltext: fulltext
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  • 1932-6203
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titleEvaluation of Systematic Assessment of Asthma-Like Symptoms and Tobacco Smoke Exposure in Early Childhood by Well-Child Professionals: A Randomised Trial
creatorGroen, E. ; van der Valk, R.J.P. ; Mohangoo, A.D. ; van der Wouden, J.C. ; Duijts, L. ; Jaddoe, V.W. ; Hofman, A. ; Koning, H.J. ; de Jongste, J.C. ; Raat, H.
contributorGeneral practice and elderly care medicine ; EMGO - Quality of care
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identifierISSN: ; ISSN: 1932-6203
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descriptionOBJECTIVES: This study aimed to evaluate the effectiveness of systematic assessment of asthma-like symptoms and environmental tobacco smoke (ETS) exposure during regular preventive well-child visits between age 1 and 4 years by well-child professionals.METHODS: Sixteen well-child centres in Rotterdam, the Netherlands, were randomised into 8 centres where the brief assessment form regarding asthma-like symptoms and ETS exposure was used and 8 centres that applied usual care. 3596 and 4179 children (born between April 2002 and January 2006) and their parents visited the intervention and control centres, respectively. At child's age 6 years, physician-diagnosed asthma ever, wheezing, fractional exhaled nitric oxide (FeNO), airway resistance (Rint), health-related quality of life (HRQOL) and ETS exposure at home ever were measured. Linear mixed models were applied.RESULTS: No differences in asthma, wheezing, FeNO, Rint or HRQOL measurements between intervention and control group were found using multilevel regression in an intention-to-treat analysis (p>0.05). Children of whom the parents were interviewed by using the brief assessment form at the intervention well-child centres had a decreased risk on ETS exposure at home ever, compared to children who visited the control well-child centres, in an explorative per-protocol analysis (aOR = 0.71, 95% CI:0.59-0.87).CONCLUSIONS: Systematic assessment and counselling of asthma-like symptoms and ETS exposure in early childhood by well-child care professionals using a brief assessment form was not effective in reducing the prevalence of physician-diagnosed asthma ever and wheezing, and did not improve FeNO, Rint or HRQOL at age 6 years. Our results hold some promise for interviewing parents and using information leaflets at well-child centres to reduce ETS exposure at home in preschool children.TRIAL REGISTRATION: Controlled-Trials.com ISRCTN15790308.
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