title: A multifaceted community-based asthma intervention in Chicago: effects of trigger reduction and self-management education on asthma morbidity.
abstract: OBJECTIVE
  Home-based, multifaceted interventions have been effective in reducing asthma morbidity in children. However, identification of independent components that contribute to outcomes and delineating effectiveness by level of asthma symptoms would help to refine the intervention and target appropriate populations.
  
  
  METHODS
  A community health educator led asthma intervention implemented in a low-income African-American neighborhood included asthma management education, individually tailored low-cost asthma home trigger remediation, and referrals to social and medical agencies, when appropriate. Changes in asthma morbidity measures were assessed in relation to implementation of individual intervention components using multivariable logistic regression.
  
  
  RESULTS
  Among the 218 children who completed the year-long program, there were significant reductions in measures of asthma morbidity, including symptoms, urgent care visits, emergency department (ED) visits, hospitalizations, missed school days, and missed work days for caretakers. We also found significant decreases in the prevalence of many home asthma triggers and improvements in asthma management practices. Improvement in caretaker's ability to manage the child's asthma was associated with reduction in ED visits for asthma and uncontrolled asthma. Specific home interventions, such as repair of water leaks and reduced exposure to plants, dust, clutter and stuffed toys, may be related to reduction in asthma morbidity.
  
  
  CONCLUSIONS
  This program was effective in reducing asthma morbidity in low-income African-American children and identified specific interventions as possible areas to target in future projects. Furthermore, the intervention was useful in children with persistent asthma symptoms as well as those with less frequent asthma exacerbations.
authors.affiliation: Division of Epidemiology and Biostatistics, University of Illinois at Chicago School of Public Health, Chicago, IL, USA. mturyk1@uic.edu
authors.forename: Mary
authors.initials: M
authors.lastname: Turyk
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Banda
authors.forename: Gay
authors.initials: G
authors.lastname: Chisum
authors.forename: Dolores
authors.initials: D
authors.lastname: Weems
authors.forename: Yangyang
authors.initials: Y
authors.lastname: Liu
authors.forename: Maureen
authors.initials: M
authors.lastname: Damitz
authors.forename: Rhonda
authors.initials: R
authors.lastname: Williams
authors.forename: Victoria
authors.initials: V
authors.lastname: Persky
mesh_terms: D000293:Adolescent; D001741:Black or African American; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001249:Asthma / Q000191:economics / Q000208:ethnology / Q000503:physiopathology* / Q000628:therapy*; D002641:Chicago; D002648:Child; D002675:Child, Preschool; D019468:Disease Management; D006798:Housing; D006801:Humans; D007223:Infant; D016015:Logistic Models; D015999:Multivariate Analysis; D010353:Patient Education as Topic / Q000379:methods* / Q000592:standards; D011203:Poverty
chemical_list: D018927:Anti-Asthmatic Agents