Aero Cavalier

Introduction and Objective: Physical activity (PA) is associated with improved asthma outcomes. Black girls face higher rates of asthma morbidity and are less likely to meet recommended PA than their White and Black male peers. To address these health disparities, it is essential to understand beliefs and behaviors related to PA among Black girls with asthma. Methods: For this qualitative study, Black girls with asthma and their mothers or female caregivers were recruited through flyers and direct outreach to patients at one academic medical center. Semi‐structured interviews focused on knowledge of PA recommendations, perceived risks and benefits of PA, barriers and facilitators to PA, and maternal influences on PA. Transcripts were coded iteratively through deductive thematic analysis. Findings: Twenty girls (age: mean = 9.9 years, SD = 1.33, range = 8–12) and their caregivers participated. Most viewed asthma as a limitation to PA and could not identify a beneficial relationship between PA and asthma. Nonetheless, girls were enthusiastic about PA and shared strategies for managing asthma symptoms while exercising. Facilitators included outdoor access and social support, while barriers included program costs and safety concerns. Many girls said they would be more active with their mother/caregiver. Conclusions: Despite personal and structural barriers to PA, Black girls with asthma view PA as important for physical and social wellbeing. Mothers/female caregivers play a major role in motivating and creating opportunities for PA. Our findings inform efforts to promote PA in a vulnerable yet understudied population, including expanding asthma management education and leveraging mother‐daughter relationships to facilitate engagement in PA.

Not-yet-known not-yet-known not-yet-known unknown Introduction and Objective: Physical activity (PA) is associated with improved asthma outcomes. Black girls face higher rates of asthma morbidity and are less likely to meet recommended PA than their White and Black male peers. To address these health disparities, it is essential to understand beliefs and behaviors related to PA among Black girls with asthma. Methods: For this qualitative study, Black girls with asthma and their mothers or female caregivers were recruited through flyers and direct outreach to patients at one academic medical center. Semi-structured interviews focused on knowledge of PA recommendations, perceived risks and benefits of PA, barriers and facilitators to PA, and maternal influences on PA. Transcripts were coded iteratively through deductive thematic analysis. Findings: Twenty girls (age: mean=9.9 years, SD=1.33, range=8-12) and their caregivers participated. Most viewed asthma as a limitation to PA and could not identify a beneficial relationship between PA and asthma. Nonetheless, girls were enthusiastic about PA and shared strategies for managing asthma symptoms while exercising. Facilitators included outdoor access and social support, while barriers included program costs and safety concerns. Many girls said they would be more active with their mother/caregiver. Conclusions: Despite personal and structural barriers to PA, Black girls with asthma view PA as important for physical and social wellbeing. Mothers/female caregivers play a major role in motivating and creating opportunities for PA. Our findings inform efforts to promote PA in a vulnerable yet understudied population, including expanding asthma management education and leveraging mother-daughter relationships to facilitate engagement in PA.

Background: Rhinitis is the most common sinonasal condition and poses a significant cost burden. Rhinitis symptom control is associated with exposure to environmental triggers (eg, aeroallergens, pollutants, and irritants). While people spend much of their time at home, studies examining the association of rhinitis symptoms with home environmental exposures, especially in low-income, urban, and racial or ethnic minorities, are limited. Frequently, 3 types of surveys are used in ecological momentary assessment (EMA): a survey conducted at a predetermined rate, an event-triggered survey, and a follow-up survey to gauge behavioral changes in response to the event. Objective: This study aims to determine the feasibility and usability of daily and triggered EMA paired with an indoor air quality monitor to collect exposure and rhinitis symptom data. Methods: Participants were recruited from the Allergy and Ear, Nose, and Throat clinics at 2 academic centers. Participants had to have a rhinitis diagnosis with active symptoms, be 18 years of age or older, self-identify as a racial or ethnic minority, live in the city of Chicago, be able to read and speak English, and have a smartphone. Participants received the Awair Omni air quality monitor to measure volatile organic compounds, particulate matter, and humidity. EMA data were collected using a personal smartphone using the PiLR Health app. Participants were sent daily scheduled surveys, random check-in surveys, and air quality event-triggered survey EMA notifications to assess rhinitis symptoms, environmental exposures, and mitigation strategies for 14 days. After the 14-day data collection period, participants completed the acceptability, appropriateness, and feasibility survey items. Feasibility metrics captured included recruitment and retention, demographics, rhinitis symptoms, and the usability of the PiLR Health App and Awair Omni. Barriers and challenges were identified and captured by the study staff. Descriptive statistics were performed using Excel (Microsoft Corp). Results: A total of 24 participants were approached, 15 participants consented and 12 participants completed the study. Participants received an average of 62.42 (SD 14.26) total surveys during their study period, and of those surveys, an average of 36.83 (SD 22.18; 59%) surveys were completed. All 12 participants met the threshold for successful home air monitoring (11 days of continuous environmental data assessment). The usability of study components and integration into the overall study was high (usability scale≥68), indicating participants considered each of the devices to be usable. Participant feedback on the study was positive; yet, they did identify areas for improvement including getting air quality data in real time, providing more detailed instructions for device setup, and doing more check-ins. Conclusions: A real-time assessment of home environmental exposures and subjective rhinitis symptoms was feasible to conduct. This study will support the development of targeted interventions to address disparities in sinonasal disease care and outcomes.

BACKGROUND Rhinitis is the most common sinonasal condition and poses a significant cost burden. Rhinitis symptom control is associated with exposure to environmental triggers (eg, aeroallergens, pollutants, and irritants). While people spend much of their time at home, studies examining the association of rhinitis symptoms with home environmental exposures, especially in low-income, urban, and racial or ethnic minorities, are limited. Frequently, 3 types of surveys are used in ecological momentary assessment (EMA): a survey conducted at a predetermined rate, an event-triggered survey, and a follow-up survey to gauge behavioral changes in response to the event. OBJECTIVE This study aims to determine the feasibility and usability of daily and triggered EMA paired with an indoor air quality monitor to collect exposure and rhinitis symptom data. METHODS Participants were recruited from the Allergy and Ear, Nose, and Throat clinics at 2 academic centers. Participants had to have a rhinitis diagnosis with active symptoms, be 18 years of age or older, self-identify as a racial or ethnic minority, live in the city of Chicago, be able to read and speak English, and have a smartphone. Participants received the Awair Omni air quality monitor to measure volatile organic compounds, particulate matter, and humidity. EMA data were collected using a personal smartphone using the PiLR Health app. Participants were sent daily scheduled surveys, random check-in surveys, and air quality event-triggered survey EMA notifications to assess rhinitis symptoms, environmental exposures, and mitigation strategies for 14 days. After the 14-day data collection period, participants completed the acceptability, appropriateness, and feasibility survey items. Feasibility metrics captured included recruitment and retention, demographics, rhinitis symptoms, and the usability of the PiLR Health App and Awair Omni. Barriers and challenges were identified and captured by the study staff. Descriptive statistics were performed using Excel (Microsoft Corp). RESULTS A total of 24 participants were approached, 15 participants consented and 12 participants completed the study. Participants received an average of 62.42 (SD 14.26) total surveys during their study period, and of those surveys, an average of 36.83 (SD 22.18; 59%) surveys were completed. All 12 participants met the threshold for successful home air monitoring (11 days of continuous environmental data assessment). The usability of study components and integration into the overall study was high (usability scale≥68), indicating participants considered each of the devices to be usable. Participant feedback on the study was positive; yet, they did identify areas for improvement including getting air quality data in real time, providing more detailed instructions for device setup, and doing more check-ins. CONCLUSIONS A real-time assessment of home environmental exposures and subjective rhinitis symptoms was feasible to conduct. This study will support the development of targeted interventions to address disparities in sinonasal disease care and outcomes.

Background: Black women experience a higher prevalence of poor asthma outcomes and physical inactivity than their White counterparts. Black women comprise a particularly vulnerable group of patients with asthma, with some of the highest rates of asthma in adults, high health care use (emergency department visits and hospitalizations), and the highest crude asthma mortality rate of all race or ethnicity groups. Despite recommendations to engage in regular physical activity, fewer than 15% of Black women meet the 2008 National Physical Activity Guidelines, the lowest of all racial subgroups of adults. Given the connection between physical inactivity and poor asthma outcomes, addressing physical activity among Black women with asthma is imperative. Objective: This 2-arm randomized controlled trial aims to (1) determine the efficacy of a lifestyle walking intervention on asthma control compared to an education (control) group over 24 weeks, (2) examine the maintenance effects of the lifestyle walking intervention on asthma control at 48 weeks, (3) explore the behavioral mediators (eg, self-efficacy, social support, self-regulation, and daily physical activity levels) and contextual moderators (eg, baseline asthma severity, neighborhood environment, comorbid conditions, and social determinants of health) that contribute to treatment responsiveness, and (4) assess the reach and implementation potential of the intervention. Methods: The proposed study (ACTION [A Lifestyle Physical Activity Intervention for Minority Women with Asthma]) delivers a 24-week lifestyle walking intervention designed for and by urban Black women with asthma. Participants (n=224) will be recruited through 2 urban health care systems that care for a diverse Black population. Patients will be randomized to one of two groups: (1) ACTION intervention (group sessions, physical activity self-monitoring—Fitbit, and text-based support for step goal setting) or (2) education control (an individual asthma education session and SMS text messages related to asthma education). Outcome assessments will take place at baseline, 12, 24, and 48 weeks. The primary outcome is a change in asthma control from baseline to week 24 as assessed by the asthma control questionnaire-6 (ACQ-6). Secondary outcomes include asthma-related quality of life, health care use, and asthma exacerbations and behavioral outcomes such as self-efficacy, self-regulation, social support, and physical activity. Results: This study was funded by the National Institute of Minority Health Disparities in August 2022. We pilot-tested our recruitment and intervention procedures and began recruitment in April 2023, with the enrollment of our first participant in May 2023. The anticipated completion of the study is April 2027. Conclusions: This study will deliver a new approach to physical activity interventions in Black women with asthma and help to provide guidance for addressing physical activity within this subgroup. This study will also provide a potential framework for future studies in minoritized populations with other disease conditions associated with low levels of physical activity. Trial Registration: ClinicalTrials.gov NCT05726487; https://clinicaltrials.gov/study/NCT05726487

BACKGROUND Black women experience a higher prevalence of poor asthma outcomes and physical inactivity than their White counterparts. Black women comprise a particularly vulnerable group of patients with asthma, with some of the highest rates of asthma in adults, high health care use (emergency department visits and hospitalizations), and the highest crude asthma mortality rate of all race or ethnicity groups. Despite recommendations to engage in regular physical activity, fewer than 15% of Black women meet the 2008 National Physical Activity Guidelines, the lowest of all racial subgroups of adults. Given the connection between physical inactivity and poor asthma outcomes, addressing physical activity among Black women with asthma is imperative. OBJECTIVE This 2-arm randomized controlled trial aims to (1) determine the efficacy of a lifestyle walking intervention on asthma control compared to an education (control) group over 24 weeks, (2) examine the maintenance effects of the lifestyle walking intervention on asthma control at 48 weeks, (3) explore the behavioral mediators (eg, self-efficacy, social support, self-regulation, and daily physical activity levels) and contextual moderators (eg, baseline asthma severity, neighborhood environment, comorbid conditions, and social determinants of health) that contribute to treatment responsiveness, and (4) assess the reach and implementation potential of the intervention. METHODS The proposed study (ACTION [A Lifestyle Physical Activity Intervention for Minority Women with Asthma]) delivers a 24-week lifestyle walking intervention designed for and by urban Black women with asthma. Participants (n=224) will be recruited through 2 urban health care systems that care for a diverse Black population. Patients will be randomized to one of two groups: (1) ACTION intervention (group sessions, physical activity self-monitoring—Fitbit, and text-based support for step goal setting) or (2) education control (an individual asthma education session and SMS text messages related to asthma education). Outcome assessments will take place at baseline, 12, 24, and 48 weeks. The primary outcome is a change in asthma control from baseline to week 24 as assessed by the asthma control questionnaire-6 (ACQ-6). Secondary outcomes include asthma-related quality of life, health care use, and asthma exacerbations and behavioral outcomes such as self-efficacy, self-regulation, social support, and physical activity. RESULTS This study was funded by the National Institute of Minority Health Disparities in August 2022. We pilot-tested our recruitment and intervention procedures and began recruitment in April 2023, with the enrollment of our first participant in May 2023. The anticipated completion of the study is April 2027. CONCLUSIONS This study will deliver a new approach to physical activity interventions in Black women with asthma and help to provide guidance for addressing physical activity within this subgroup. This study will also provide a potential framework for future studies in minoritized populations with other disease conditions associated with low levels of physical activity. CLINICALTRIAL ClinicalTrials.gov NCT05726487; https://clinicaltrials.gov/study/NCT05726487 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/55700