Study in AJPH by Krieger et al about Seattle's community health worker-based home intervention to decrease exposure to environmental asthma triggers

Krieger JW, Takaro TK, Song L, Weaver M. 2005. The Seattle-King County Healthy Homes Project: A Randomized, Controlled Trial of a Community Health Worker Intervention to Decrease Exposure to Indoor Asthma Triggers. American Journal of Public Health (AJPH), 95 (4): 652-659. This was a randomized control trial with one year of follow-up. In Seattle-King County, WA, 274 eligible (of 1, 116 study population) low-income households with a child 4-12 years old with doctor-diagnosed asthma were divided into two groups: high-intensity intervention and low-intensity intervention. The intervention involved trained community health workers who made seven visits with a full set of resources (high-intensity) or one visit with a few resources (low-intensity). The first visit included an in-home environmental assessment and a baseline interview questionnaire. Resources included educational materials and/or addressed support for positive behavior changes with respect to measured clinical and environmental management outcomes. About 80% of subjects in both the high-intensity and low-intensity intervention groups completed the exit interview survey; about 60% of those subjects in the high-intervention group also completed a six-month post-intervention interview questionnaire. Comparing baseline to exit interview results, the high-intensity intervention led to statistically significant benefits including: * About a 60% decline in urgent health services use in the last two months; * About a 70% decline in days with reported activity limitations in the last two weeks. In addition, both intervention protocols statistically significantly: * Reduced the number of days with asthma symptoms in the last two weeks; * Increased the caregiver quality-of-life score; * Reduced the number of days emergency inhaler medication was used in the last two weeks. Also, the high-intensity intervention statistically significantly: * Reduced the number of days controller medication was used in the last two weeks; *Reduced the number of children who missed one or more days of school in the past two weeks. With respect to environmental asthma trigger interventions, both protocols led to statistically significant positive behavior changes related to controlling levels of dust mites, particles and humidity (moisture, a requirement for mold growth), but not with respect to smoking in the home. To read the abstract to this article, please go to: //www.ajph.org/cgi/content/abstract/95/4/652 NOTE: If your organization has on-line membership access, you can download the full paper from this website page as well.

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