Impact of a household environmental intervention delivered by lay health workers on asthma symptom control in urban, disadvantaged children with asthma.
OBJECTIVE
We examined whether a home-based educational and environmental intervention delivered by lay health educators would improve asthma symptom control in inner-city children with asthma.


METHODS
Children 2 to 16 years of age with diagnosed asthma and at least 1 asthma-related hospitalization or 2 emergency visits in the prior year were randomly assigned into 2 groups (immediate and delayed intervention) in a crossover study. Each group participated in the active phase (intervention) and the inactive phase. Outcomes included asthma symptoms, albuterol use, emergency department visits, hospitalizations, and trigger reduction.


RESULTS
A total of 264 primarily Black (94%) children were enrolled. The mean number of emergency visits decreased by 30% and inpatient visits decreased by 53% (P < .001) after the intervention. Reductions were seen in pests, presence of carpets in bedrooms, and dust. Nighttime wheezing was significantly reduced after the intervention in both groups (P < .001).


CONCLUSIONS
Lay health educators effectively reduced asthma triggers and increased caregiver asthma knowledge, which resulted in reduced emergency department visits, hospitalizations, and asthma symptoms. The relationships formed between the caregivers and the lay health educators appeared to positively impact asthma outcomes in this disadvantaged population.
Bryant-Stephens
Tyra
T
Department of General Pediatrics and Ambulatory Care, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA. stephenst@mail.chop.edu
Kurian
Cizely
C
Guo
Rong
R
Zhao
Hauqing
H
D000293:Adolescent; D001249:Asthma / Q000188:drug therapy* / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D018592:Cross-Over Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel; D006798:Housing; D006801:Humans; D008297:Male; D011203:Poverty; D015397:Program Evaluation; D014481:United States; D014505:Urban Population