Research Design 1st Submission

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DE LA SALLE HEALTH SCIENCES INSTITUTE COLLEGE OF MEDICINE

DEPARTMENT OF FAMILY AND COMMUNITY MEDICINE

CM2 SY 2011-2012

OUTPUT 3: RESEARCH DESIGN

I. Group 1A, Dr. Jovilia M. Abong

II. Research Question: Among students aged 13-14 with allergic rhinitis of selected schools in

Dasmarias, Cavite, will exposure to air-conditioned school rooms exacerbate their allergic rhinitis?

General Objective: To determine if the exposure to the air-conditioning system exacerbates allergic

rhinitis in high school students, aged 13-14, of selected schools in Dasmarias, Cavite.

Specific Objectives:

1. To identify the prevalence of allergic rhinitis among high school students, aged 13-14, of

selected schools in of Dasmarias, Cavite based on their exposure to air-conditioned rooms.

2. To identify the prevalence of allergic rhinitis among high school students, aged 13-14, of

selected schools in Dasmarias, Cavite based on their exposure to non-air-conditioned

classrooms.

3. To determine the severity of allergic rhinitis according to ARIA classifications.

4. To identify the risk factors of allergic rhinitis present in the classroom or school.

5. To determine the number of hours exposed to the classroom with or without air-conditioning

system.

6. Compare the severity of allergic rhinitis in students who are exposed to air-conditioned

classrooms and those who are not exposed to air-conditioned classrooms.

7. To determine which studying environment is more suitable in the prevention of allergic

rhinitis.

III. Background

a. Research Hypothesis: Exposure to air-conditioned rooms alleviates the symptoms and

occurrence of allergic rhinitis and poor ventilation leads to its exacerbation.

b. Conceptual Framework:

Exposure Variable Disease Variable

Exposure to Air-

conditioning System

Improves allergic Rhinitis

Exacerbates Allergic Rhinitis

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+

-

Allergens/Irritants

Number of hours spent in classroom

Condition of the room

Confounders


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Animal dander is loose skin cells from animals which contain secretion from glands in

the animals skin. These skin cells float in the air where they may be breathed in by people. The

animals fur or hair per se is not an allergen, but there might be dried saliva on the hair that may

bring about the allergy. [1]

Pollens causes allergic reactions. These are tiny and come from plants (trees, grasses,

ragweed, etc.). The amount of pollen in the air plays a role in developing allergic reaction.

There is likely increased amounts of pollen in hot, dry and windy days, while a decreased

amount during cool, damp and rainy days. [5]

According to an article by deShazo and Kemp, the spores coming from molds can be a

trigger in releasing the symptoms of allergic rhinitis. Also, according to them, mold thrives in

damp environments such as air conditioning vents, water traps, refrigerator drip trays, shower

stalls, leaky sinks, and damp basements if not cleaned regularly. Under certain conditions, the

growth of these organisms can be considerable and exacerbate allergy symptoms. [6] Since

allergic rhinitis is difficult to cure, the focus is on preventing the attack of the symptoms.

Many different triggers that may cause a student to experience symptoms of asthma and

allergy are found inside a typical classroom. These triggers include the pollens from the plants

found near or inside a classroom, dust mites and mold spores. The cleanliness of the room may

also play a factor in triggering the allergic reactions. The students themselves may also carry

allergens produced by their pet cats or dogs which may cling to their clothes and trigger an

allergic reaction when the students come in contact with them. Chalk dusts are also usually the

causes of allergic reactions inside the classroom since the teachers usually use chalk for writing

on the green boards. [7]

b. Research Design

i. Type of study to be employed

The type of study that the researchers are going to be implementing is a cross-sectional research

design. The researchers deem this the most necessary research design just to see whether or not

there is a relationship between the number of hours exposed to air-conditioning systems and the

exacerbation of Allergic Rhinitis. Moreover, this research design is appropriate because the

Disease Variable of the research, which is Allergic Rhinitis, is not a rare disease (thus

eliminating the use of a case-control study). However, in doing a cross-sectional study, the

researchers must take note of and control the confounding variablesways of which will be

discussed in the latter part of the description of the research design.

ii. Definition of study groups population and sources of subjects.

The study population will be 13-14 year old children who, in the Philippine setting, are

approximately first year high school students. From this population, a sample of students who

have AR will be considered for the study. The sample populations will be gathered from select

schools in Dasmarias, Cavite, ideally one private and public school in order to acquire subjects

that have exposure to an air conditioned school environment and one that is not.

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iii. Steps to be undertaken:

These are the steps to be done in our procedure to collect data for this project:

1. Evaluate the classroom conditions of each school.

The group will visit each high school and evaluate the environmental conditions of eachclassroom that will be part of the research. A checklist will be used to document and evaluate

the conditions.

2. Screen students for allergic rhinitis.

Each student will be screened through a questionnaire, based on the ARIA questionnaire, to

eliminate those who do not have allergic rhinitis from the study group. This will help in making

the research study more specific to those who have allergic rhinitis and how the classroom

conditions can alleviate or exacerbate their symptoms.

3. Determine what conditions or things in the classroom, particularly the presence or

absence of an air-conditioning system, exacerbates or relieves each students allergic rhinitis.

A questionnaire will be given to each student who has AR in which it will ask them if their

symptoms are better or worse when they are in the classroom and what specific conditions help

or harm them.

4. Evaluate each students questionnaire.

Each students questionnaire will be evaluated to see what particular conditions exacerbate and

relieve their AR symptoms. There will also be a particular focus on whether having an air-

conditioning system present or not alleviates or worsens each students AR symptoms. [8]

iv. Schematic Diagram

Measure of Association: Prevalence Ratio

Exacerbation of

Allergic

Rhinitis

(+) (-) Total

Air-

Conditioning

(+) A B A+B

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System

(-) C D C+D

Total A+C B+D A+B+C+D

Cross-Sectional Study

Effects of exposure to air-conditioning systems

In the exacerbation of Allergic Rhinitis

Sample Population to be Tested

13-14 year-old high school students from selected

High Schools in Dasmarinas, Cavite.

Procedure

1. Evaluate classroom conditions.

2. Screen students for allergic rhinitis.

3. Determine what conditions or things in

the classroom, particularly the presence orabsence of an air-conditioning system,

exacerbates or relieves each students allergic

rhinitis.

4. Evaluate student questionnaires.

c. Biases/Limitations

i. Enumeration of all biases/limitations

The study will only focus on the role of ventilation inside the classrooms in the relief and

exacerbation of allergic rhinitis among students aged 13-14 years old studying in Dasmarias,

Cavite. It will not include other respiratory diseases and illness that may be affected by the

difference in ventilation.

The possible biases in the study are:

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Selection bias

Expectation bias

ii. Plan to minimize these biases in the study

Selection bias may happen when subjects being compared are not similar, and may result todata that is not representative of the population of interest. [9] With the use of proper screening

methods for the study population, we will select subjects that are similar in almost all aspects in

order to gather a more representative and comparable data.

Expectation bias happens when there is no masking or blinding implemented in the study

and this may influence and tarnish the data to be gathered towards the expected or desired

outcome. [9] To minimize this bias, a high level of objectivity must be maintained with each of

the members of the group of researchers in the gathering of data and its analysis.

Bibliography

[1] Healthwise Staff, Allergic Rhinitis, In: Thompson, E.G. MD, Nelson, H.S. MD, editor, Allergic

Rhinitis [cited 2011 July 31] Available from: http://www.webmd.com/allergies/tc/allergic-

rhinitis-overview

[2] Allergic rhinitis. (2010). Health encyclopedia diseases and conditions. Retrieved July 10, 2011,

from http://www.healthscout.com/ency/68/208/main.html.

[3] Retrieved on July 30, 2011 from

http://www.studenthealth.gov.hk/english/health/health_ophp/health_ophp_nos.html

[4] Air conditioner. (2009).Air conditioning and refrigeration information. Retrieved July 30, 2011, from

http://www.air-conditioning-and-refrigeration.com/air-conditioner.html.

[5] Busse, P.J. MD., (2010) Allergic Rhinitis In: Zieve, D. MD., editor., [cited 2011 July 31] Available

from: http://www.nlm.nih.gov/medlineplus/ency/article/000813.htm

[6] deShazo R., Patient Information: Trigger avoidance in allergic rhinitis. Retrieved on July 30, 2011

from http://www.uptodate.com/contents/patient-information-trigger-avoidance-in-allergic-rhinitis

[7] Health risks in the classroom: children with asthma and allergies need to take special precautions at

school. Retrieved July 30, 2011, from

http://www.kidneeds.com/diagnostic_categories/articles/classrisks01.htm.

[8] ARIA Questionnaire. Allergic Rhinitis and its Impact on Asthma [Website]. 2011 [cited 2011 July 30].

Available from http://www.whiar.org/Questionnaire.php.

[9] Hartman, J.M., Forsen, J.W., Wallace, M.S., Neely, J.G. (2002). Tutorials in clinical research: Part IV:

Recognizing and controlling bias.Laryngoscope, 112, 23-31.

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http://www.webmd.com/allergies/tc/allergic-rhinitis-overviewhttp://www.webmd.com/allergies/tc/allergic-rhinitis-overviewhttp://www.healthscout.com/ency/68/208/main.htmlhttp://www.nlm.nih.gov/medlineplus/ency/article/000813.htmhttp://www.webmd.com/allergies/tc/allergic-rhinitis-overviewhttp://www.webmd.com/allergies/tc/allergic-rhinitis-overviewhttp://www.healthscout.com/ency/68/208/main.htmlhttp://www.nlm.nih.gov/medlineplus/ency/article/000813.htm


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Research Design 1st Submission

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