title: Effect of environmental interventions to reduce exposure to asthma triggers in homes of low-income children in Seattle.
abstract: The effectiveness of community health workers (CHWs) assisting families in reducing exposure to indoor asthma triggers has not been studied. In all, 274 low-income asthmatic children were randomly assigned to high- or low-intensity groups. CHWs visited all homes to assess exposures, develop action plans and provide bedding encasements. The higher-intensity group also received cleaning equipment and five to nine visits over a year focusing on asthma trigger reduction. The asthma trigger composite score decreased from 1.56 to 1.19 (Delta=-0.37, 95% CI 0.13, 0.61) in the higher-intensity group and from 1.63 to 1.43 in the low-intensity group (Delta=-0.20, 95% CI 0.004, 0.4). The difference in this measure due to the intervention was significant at the P=0.096 level. The higher-intensity group also showed improvement during the intervention year in measurements of condensation, roaches, moisture, cleaning behavior, dust weight, dust mite antigen, and total antigens above a cut point, effects not demonstrated in the low-intensity group. CHWs are effective in reducing asthma trigger exposure in low-income children. Further research is needed to determine the effectiveness of specific interventions and structural improvements on asthma trigger exposure and health.
authors.affiliation: Occupational and Environmental Medicine, University of Washington School of Public Health and Community Medicine, Seattle, WA 98105, USA. ttakaro@u.washington.edu
authors.forename: Tim K
authors.initials: TK
authors.lastname: Takaro
authors.forename: James W
authors.initials: JW
authors.lastname: Krieger
authors.forename: Lin
authors.initials: L
authors.lastname: Song
mesh_terms: D016902:Air Pollution, Indoor / Q000517:prevention & control*; D000818:Animals; D000941:Antigens / Q000032:analysis; D001249:Asthma / Q000209:etiology / Q000517:prevention & control*; D002648:Child; D002675:Child, Preschool; D003058:Cockroaches; D003150:Community Health Workers; D004391:Dust; D004493:Education; D005260:Female; D006798:Housing; D006801:Humans; D006920:Hygiene; D008297:Male; D011203:Poverty; D014505:Urban Population; D014861:Washington
chemical_list: D000941:Antigens; D004391:Dust