Study by Takaro et al. in special issue of JEAEE (Vol.14 Suppl 1) about healthy homes environmental interventions by community health workers in Seattle/King County, WA

“Takaro TK, Krieger JW, Song L. 2004. Effect of environmental interventions to reduce exposure to asthma triggers in homes of low-income children in Seattle. Journal of Exposure Analysis and Environmental Epidemiology, 14 (Suppl 1), S133-S143. This study documented the effectiveness of community health workers (CHWs) in assisting families to reduce exposures to dust particles and biological agents known to be asthma triggers, including conditions indoors which could lead to the presence of those triggers (e.g., condensation on surfaces, water damaged materials). This CHW intervention combined a visit to each study home (n=274) for education, for qualitative and/or quantitative assessment of potential exposures, development of action plans, and provision of non-allergenic encasements for bedding. The difference between what the authors named high intensity”” and “”low intensity”” groups was CHWs visited homes in the “”high intensity”” group 4-8 more times over the course of one year, and provided cleaning equipment. 79.7% of homes in the “”high intensity”” group finished the study (110 of 138), and 76.5% of homes in the “”low intensity”” group finished the study (104 of 136), which may reflect the repeated CHW visits over the year. Overall, the results suggested community health worker-based education interventions benefit asthmatic children in low-income housing in major urban areas like Seattle. While many results presented in the data tables were not statistically significant, either likely due to small sample sizes after stratification or because there were no changes in some behaviors or potential exposures, there were several important statistically significant findings (p-value < 0.05) when comparing “”high intensity”” versus “”low intensity”” groups. These included: * More homes vacuumed the child’s bedroom, and cloth-covered furniture, at least twice every two weeks. * More homes used doormats and/or removed shoes, which can reduce the amount of soil (dust particles) brought in from outdoors. * More homes used the allergy control covers on mattresses and pillows, whether or not provided by the CHWs as part of the study intervention, though relatively more homes in the “”high intensity”” group used them. * More homes had, and used, a working bathroom exhaust fan, which provides ventiliation to minimize relative humidity and condensation build-up and thus the potential for moisture damage and mold as well as dust mites in adjacent rooms. * Less reported and/or observed presence of condensation and cockroaches. * Reduced dust weights (grams per square meter, after mesh sieve), which likely reflects the increased vacuuming and use of door mats. Please note the May 2004 CAFA Briefing Kit science fact sheets have, among peer-reviewed references up to March 2004, several from this public health research team in Seattle/King County, WA. For convenience, those listed below are from the “asthma and IAQ in the home” fact sheet’s references list, both of which are available on WWW at: // 3. Krieger JW, Song L, Takaro TK, Stout J. 2000. Asthma and the home environment of low-income urban children: preliminary findings from the Seattle-King County healthy homes project. J Urban Health, 77 (1): 50-67. 60. Krieger JK, Takaro TK, Allen C, Song L, Weaver M, Chai S, Dickey P. 2002. The Seattle-King County healthy homes project: implementation of a comprehensive approach to improving indoor environmental quality for low-income children with asthma. Environ Health Perspect, 110 (Suppl 2): 311-322.”””