The Seattle-King County Healthy Homes Project: a randomized, controlled trial of a community health worker intervention to decrease exposure to indoor asthma triggers.
OBJECTIVE
We assessed the effectiveness of a community health worker intervention focused on reducing exposure to indoor asthma triggers.


METHODS
We conducted a randomized controlled trial with 1-year follow-up among 274 low-income households containing a child aged 4-12 years who had asthma. Community health workers provided in-home environmental assessments, education, support for behavior change, and resources. Participants were assigned to either a high-intensity group receiving 7 visits and a full set of resources or a low-intensity group receiving a single visit and limited resources.


RESULTS
The high-intensity group improved significantly more than the low-intensity group in its pediatric asthma caregiver quality-of-life score (P=.005) and asthma-related urgent health services use (P=.026). Asthma symptom days declined more in the high-intensity group, although the across-group difference did not reach statistical significance (P=.138). Participant actions to reduce triggers generally increased in the high-intensity group. The projected 4-year net savings per participant among the high-intensity group relative to the low-intensity group were 189-721 dollars.


CONCLUSIONS
Community health workers reduced asthma symptom days and urgent health services use while improving caregiver quality-of-life score. Improvement was greater with a higher-intensity intervention.
Krieger
James W
JW
Public Heath-Seattle and King County, 999 Third Avenue, Suite 1200, Seattle, WA 98104, USA. james.krieger@metrokc.gov
Takaro
Tim K
TK
Song
Lin
L
Weaver
Marcia
M
D016902:Air Pollution, Indoor / Q000517:prevention & control*; D001249:Asthma / Q000453:epidemiology / Q000517:prevention & control*; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D003153:Community Health Services / Q000458:organization & administration*; D003150:Community Health Workers; D005260:Female; D006798:Housing; D006801:Humans; D016015:Logistic Models; D008297:Male; D011203:Poverty; D015995:Prevalence; D015397:Program Evaluation; D012307:Risk Factors; D018709:Statistics, Nonparametric; D014504:Urban Health; D014861:Washington / Q000453:epidemiology