title: Home visits are needed to address asthma health disparities in adults.
abstract: Research on asthma frequently recruits patients from clinics because the ready pool of patients leads to easy access to patients in office waiting areas, emergency departments, or hospital wards. Patients with other chronic conditions, and with mobility problems, face exposures at home that are not easily identified at the clinic. In this article, we describe the perspective of the community health workers and the challenges they encountered when making home visits while implementing a research intervention in a cohort of low-income, minority patients. From their observations, poor housing, often the result of poverty and lack of social resources, is the real elephant in the chronic asthma room. To achieve a goal of reduced asthma morbidity and mortality will require a first-hand understanding of the real-world social and economic barriers to optimal asthma management and the solutions to those barriers.
authors: Children's Hospital of Philadelphia, Philadelphia, Pa; Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa. Electronic address: stephenst@email.chop.edu.
authors: Tyra
authors: T
authors: Bryant-Stephens
authors: Children's Hospital of Philadelphia, Philadelphia, Pa.
authors: Shakira
authors: S
authors: Reed-Wells
authors: Children's Hospital of Philadelphia, Philadelphia, Pa.
authors: Maryori
authors: M
authors: Canales
authors: Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa; Division of Pulmonary, Allergy, & Critical Care Medicine, Department of Medicine, Philadelphia, Pa.
authors: Luzmercy
authors: L
authors: Perez
authors: Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa.
authors: Marisa
authors: M
authors: Rogers
authors: Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa; Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pa.
authors: A Russell
authors: AR
authors: Localio
authors: Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa; Division of Pulmonary, Allergy, & Critical Care Medicine, Department of Medicine, Philadelphia, Pa.
authors: Andrea J
authors: AJ
authors: Apter
mesh_terms: D000328:Adult; D001249:Asthma / Q000453:epidemiology*; D003150:Community Health Workers; D019058:Community Networks; D054625:Healthcare Disparities; D006792:House Calls; D006801:Humans; D063868:Patient Outcome Assessment; D011203:Poverty; D014481:United States
keywords: Asthma; community health worker; health disparities; housing; patient-centered outcomes research