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Trial registered on ANZCTR
Registration number
ACTRN12621000906853
Ethics application status
Approved
Date submitted
4/05/2021
Date registered
13/07/2021
Date last updated
16/04/2024
Date data sharing statement initially provided
13/07/2021
Type of registration
Prospectively registered
Titles & IDs
Public title
Short-term exposure to biodiversity and health in children with asthma
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Scientific title
Does short-term exposure to biodiversity affect gut microbiota, immunity, and asthma and allergy symptoms in children with asthma?
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Secondary ID [1]
304126
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None
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Universal Trial Number (UTN)
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Trial acronym
STEALTH (Short Term Exposure to biodiversity and heALTH in children with asthma)
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Allergic asthma
321812
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Asthma
321813
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Allergy
321814
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Condition category
Condition code
Respiratory
319542
319542
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0
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Asthma
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Inflammatory and Immune System
319543
319543
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0
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Allergies
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
This study is now a single-period non-randomised trial. All participants will be assessed at baseline, and then asked to visit a high vegetation diverse area (described below) at least twice, and for a minimum of 2 hours a week, for a 3-month period. For these periods they will be asked to walk/spend time in close proximity to vegetation. During this period participants will be asked to keep a diary of their visits and we will collect admission data from Zealandia to determine adherence. At the end of the 3-month period, all participants will be assessed. Local areas of high native vegetation diversity around Wellington, New Zealand (including Zealandia ecosanctuary) will be used as the site of high biodiverse exposure. Vegetation diversity will be quantified using normalised difference vegetation index (NDVI) and the Land-Cover Database (Landcare Research NZ),
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Intervention code [1]
320460
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Treatment: Other
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Comparator / control treatment
No control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Change in asthma control questionnaire (ACQ-7) score
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Assessment method [1]
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Timepoint [1]
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Baseline; 3 months after initiation of intervention period
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Primary outcome [2]
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Change in asthma and allergy symptoms (as assessed by International Study on Allergies and Asthma in Childhood (ISAAC) Phase II survey)
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Assessment method [2]
328018
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Timepoint [2]
328018
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Baseline; 3 months after initiation of intervention period
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Primary outcome [3]
328019
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Change in Fractional Exhaled Nitric Oxide (FENO) levels- assessed using a FENO analyser
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Assessment method [3]
328019
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Timepoint [3]
328019
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Baseline; 3 months after initiation of intervention period
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Secondary outcome [1]
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Change in lung function (FEV1, FVC, FEV1/FVC) as assessed by spirometry
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Assessment method [1]
394971
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Timepoint [1]
394971
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Baseline; 3 months after initiation of intervention period
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Secondary outcome [2]
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Change in peak expiratory flow (PEF) variability as assessed by spirometry and PEF meters
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Assessment method [2]
397234
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Timepoint [2]
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Baseline; 3 months after initiation of intervention period
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Secondary outcome [3]
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Change in blood markers (serum cytokines (IL-5, IL-6, IL-10, IL-13, IL-17, IFN-g, TNF-a) assessed by cytokine bead array, and complete blood count-assessed using a haematology analyser)
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Assessment method [3]
397235
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Timepoint [3]
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Baseline; 3 months after initiation of intervention period
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Secondary outcome [4]
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Change in gut microbiome characteristics, as assessed by 16s sequencing
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Assessment method [4]
397236
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Timepoint [4]
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Baseline; 3 months after initiation of intervention period
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Secondary outcome [5]
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Change in wellbeing (based on World Health Organisation (WHO)-5 questionnaire)
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Assessment method [5]
397237
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Timepoint [5]
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Baseline; 3 months after initiation of intervention period
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Secondary outcome [6]
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Change in Nature Connection Index (NCI) score-assessed using the NCI questionnaire
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Assessment method [6]
397238
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Timepoint [6]
397238
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Baseline; 3 months after initiation of intervention period
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Secondary outcome [7]
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Change in wellbeing (based on Kessler-6 questionnaire)
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Assessment method [7]
398134
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Timepoint [7]
398134
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Baseline; 3 months after initiation of intervention period
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Eligibility
Key inclusion criteria
Doctor's diagnosis of asthma and reported wheeze in the last 12 months
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Minimum age
11
Years
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Maximum age
18
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Other significant cardiac or pulmonary diseases.
Regular use of oral corticosteroid medication.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Allocation is not concealed
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Non-randomised
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Based on studies in which subjects completed the asthma control questionnaire (ACQ7) repeatedly over time, we assume a within-subject variance of the ACQ score to be 0.18 with a mean ACQ score of 1.49. With a total of 50 asthma subjects (we will oversample by 20% to compensate for loss-to-follow up) we will have 80% power to detect a 6% difference and 90% power to detect a 12% difference in ACQ score. For other outcomes, study power is likely to be less, but sufficient to demonstrate general trends.
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
24/11/2023
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Actual
24/11/2023
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Date of last participant enrolment
Anticipated
7/02/2025
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Actual
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Date of last data collection
Anticipated
31/12/2025
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Actual
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Sample size
Target
60
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Accrual to date
20
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Final
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Recruitment outside Australia
Country [1]
23672
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New Zealand
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State/province [1]
23672
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Wellington
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Funding & Sponsors
Funding source category [1]
308504
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Government body
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Name [1]
308504
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NZ Health Research Council - Sir Charles Hercus Fellowship
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Address [1]
308504
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Health Research Council
PO Box 5541
Victoria Street West
Auckland
1142
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Country [1]
308504
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New Zealand
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Primary sponsor type
University
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Name
Research Centre for Hauora and Health (Formerly Centre for Public Health Research), Massey University
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Address
Research Centre for Haurora and Health
Massey University Wellington Campus
PO Box 756
Wellington 6140
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Country
New Zealand
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Secondary sponsor category [1]
309358
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None
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Name [1]
309358
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Address [1]
309358
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Country [1]
309358
0
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
308465
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Northern A Health and Disability Ethics Committee
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Ethics committee address [1]
308465
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https://ethics.health.govt.nz/about/northern-a-health-and-disability-ethics-committee/
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Ethics committee country [1]
308465
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New Zealand
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Date submitted for ethics approval [1]
308465
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13/03/2023
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Approval date [1]
308465
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28/04/2023
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Ethics approval number [1]
308465
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2023 AM 10811
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Summary
Brief summary
The purpose of the study is to determine if short-term exposure to biodiverse environments modulates or affects gut microbiota, immune responses, FENO, lung function and asthma and allergy symptoms in a group of children with asthma. We hypothesise that exposure to biodiversity may improve asthma symptoms and control, and that this effect may be driven by the more abundant and numerous bacteria present in biodiverse environments.
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Trial website
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Trial related presentations / publications
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Public notes
This study was orignially a crossover trial, in which all participants would undergo intervention and control periods, and be randomly assigned to the two crossover groups. However, due to COVID related delays, it has been updated and shortened to a single period non-randomised trial.
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Contacts
Principal investigator
Name
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Dr Collin Brooks
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Address
110782
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Research Centre for Hauora and Health
Massey University Wellington Campus
Private Bag 756
Wellington
6140
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Country
110782
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New Zealand
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Phone
110782
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+64 4 9793093
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Fax
110782
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Email
110782
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[email protected]
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Contact person for public queries
Name
110783
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Collin Brooks
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Address
110783
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Research Centre for Hauora and Health
Massey University Wellington Campus
Private Bag 756
Wellington
6140
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Country
110783
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New Zealand
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Phone
110783
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+64 4 9793093
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Fax
110783
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Email
110783
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[email protected]
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Contact person for scientific queries
Name
110784
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Collin Brooks
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Address
110784
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Research Centre for Hauora and Health
Massey University Wellington Campus
Private Bag 756
Wellington
6140
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Country
110784
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New Zealand
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Phone
110784
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+64 4 9793093
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Fax
110784
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Email
110784
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
No IPD will be shared for ethical reasons.
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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