Evaluation of a Program to Reduce Home Environment Risks for Children with Asthma Residing in Urban Areas
Brandon Workman1, Andrew F Beck2, Nicholas C Newman1,2
1Department of Environmental and Public Health Sciences, University of Cincinnati, Cincinnati, OH 45267-0056, USA.
Insights
Multimodal home visits effectively address pediatric asthma triggers by providing education and remediation services. While beneficial, some families express mistrust towards health department staff, necessitating further investigation.
Area of Science:
- Environmental Health
- Pediatric Pulmonology
- Public Health Interventions
Background:
- Pediatric asthma morbidity is exacerbated by poor housing quality, limited healthcare access, and medication non-adherence, perpetuating racial and income disparities.
- Multimodal home visits are a proven strategy to mitigate these challenges and improve asthma-related outcomes.
- The Collaboration to Lessen Environmental Asthma Risks (CLEAR) program utilizes home visits for education and remediation orders.
Purpose of the Study:
- To evaluate the strengths and weaknesses of the CLEAR program.
- To gather qualitative feedback from healthcare professionals and mothers of children with asthma.
Main Methods:
- Key informant interviews were conducted with health professionals and mothers of children recently hospitalized with asthma.
- Qualitative data was analyzed to identify program successes and areas for improvement.
Main Results:
- Health professionals perceive CLEAR as a valuable support system, emphasizing the benefits of education on asthma triggers and service connection for home improvements.
- Mothers reported implementing changes to home asthma triggers based on received education.
- Some mothers expressed mistrust towards health department staff, highlighting a need for further research into its origins.
Conclusions:
- The CLEAR program demonstrates success in supporting families and educating them about home asthma triggers.
- Addressing mistrust towards health department staff is crucial for program enhancement.
- Further research is needed to understand and mitigate sources of mistrust for improved program efficacy.
Abstract:
Pediatric asthma morbidity is often linked to challenges including poor housing quality, inability to access proper medical care, lack of medications, and poor adherence to medical regimens. Such factors also propagate known disparities, by race and income, in asthma-related outcomes. Multimodal home visits have an established evidence base in support of their use to improve such outcomes. The Collaboration to Lessen Environmental Asthma Risks (CLEAR) is a partnership between the Cincinnati Children's Hospital Medical Center and the local health department which carries out home visits to provide healthy homes education and write orders for remediation should code violations and environmental asthma triggers be identified. To assess the strengths and weaknesses of the program, we obtained qualitative feedback from health professionals and mothers of children recently hospitalized with asthma using key informant interviews. Health professionals viewed the program as a positive support system for families and highlighted the potential benefit of education on home asthma triggers and connecting families with services for home improvements. Mothers report working to correct asthma triggers in the home based on the education they received during the course of their child's recent illness. Some mothers indicated mistrust of the health department staff completing home visits, indicating a further need for research to identify the sources of this mistrust. Overall, the interviews provided insights into successful areas of the program and areas for program improvement.
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