Effect of weatherization combined with community health worker in-home education on asthma control.
OBJECTIVE
We assessed the benefits of adding weatherization-plus-health interventions to an in-home, community health worker (CHW) education program on asthma control.


METHODS
We used a quasi-experimental design to compare study group homes (n = 34) receiving CHW education and weatherization-plus-health structural interventions with historical comparison group homes (n = 68) receiving only education. Data were collected in King County, Washington, from October 2009 to September 2010.


RESULTS
Over the 1-year study period, the percentage of study group children with not-well-controlled or very poorly controlled asthma decreased more than the comparison group percentage (100% to 28.8% vs 100% to 51.6%; P = .04). Study group caregiver quality-of-life improvements exceeded comparison group improvements (P = .002) by 0.7 units, a clinically important difference. The decrease in study home asthma triggers (evidence of mold, water damage, pests, smoking) was marginally greater than the comparison group decrease (P = .089). Except for mouse allergen, the percentage of study group allergen floor dust samples at or above the detection limit decreased, although most reductions were not statistically significant.


CONCLUSIONS
Combining weatherization and healthy home interventions (e.g., improved ventilation, moisture and mold reduction, carpet replacement, and plumbing repairs) with CHW asthma education significantly improves childhood asthma control.
Jill Breysse, Sherry Dixon, and David E. Jacobs are with the National Center for Healthy Housing, Columbia, MD. Joel Gregory is with the King County Housing Authority, Tukwila, WA. Miriam Philby and James Krieger are with Public Health-Seattle and King County, Seattle, WA.
Jill
J
Breysse
Sherry
S
Dixon
Joel
J
Gregory
Miriam
M
Philby
David E
DE
Jacobs
James
J
Krieger
D000293:Adolescent; D001249:Asthma / Q000453:epidemiology / Q000208:ethnology / Q000517:prevention & control*; D002648:Child; D002675:Child, Preschool; D003150:Community Health Workers; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D006266:Health Education / Q000458:organization & administration*; D006798:Housing; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D057216:Propensity Score; D014861:Washington / Q000453:epidemiology; D014887:Weather