Study by Takaro et al. in JEAEE (Vol. 14 Suppl 1) about effectiveness of 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 investigated the effectiveness of community health workers (CHWs) in providing an education and assessment-based intervention to assist families to reduce exposure to known asthma triggers indoors like dust particles and biological agents (mold, cockroaches), and underlying conditions which may lead to these exposures (condensation build-up, leaks, moisture damage). CHWs visited 274 homes for education, a qualitative and quantitative assessment of potential exposures to targeted asthma triggers, and development of action plans. The difference in what the authors termed high intensity”” and “”low intensity”” groups of intervention homes was CHWs visited homes in the “”high intensity”” group 4-8 times more during the study year for repeated education, and provided cleaning equipment. There were 79.7% of homes (110 of 138) in the “”high intensity”” group, and 76.5% of homes (104 of 136) in the “”low intensity”” group, completing the study, which may reflect a benefit of repeated education visits by CHWs. Overall, this study’s data suggested community health worker-based home interventions can benefit asthmatic children living in low-income housing in urban areas like Seattle. Though many results presented in the data tables were not statistically significant, either due to small sample sizes after stratification or because the behavior or potential exposure did not change from baseline to end of study, there were several important statistically significant findings (p-value less than 0.05) when comparing “”high intensity”” and “”low intensity”” homes and for the study group overall. These included: * More homes vacuumed the child’s bedroom, and cloth-covered furniture, at least two times each two weeks, which reduces dust levels. * More homes used doormats and/or removed shoes, which reduces the amount of dust particles (soil, and constituents) brought in from outdoors. * More homes used allergy control covers on bedding (mattress, pillow). * More homes had, and used, a working bathroom exhaust fan, which reduces relative humidity and condensation build-up. * Less condensation and roaches were reported and/or observed after the intervention program. * The weight of collected dust decreased after the intervention program. Please note the CAFA Briefing Kit fact sheets have, among peer-reviewed references up to March 2004, several from this public health research team in Seattle/King County. For your convenience, these references listed below are from the “asthma and IAQ in the home” fact sheet’s references list, both of which are available for download from: // 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.”””