title: Addressing asthma and obesity in children with community health workers: proof-of-concept intervention development.
abstract: The objective of this study was to design and test the feasibility and impact of a community health worker (CHW) intervention for comorbid asthma and obesity.
  
  
  
  Using a proof of concept study design, we collected pre/post outcomes from a single intervention cohort of urban low-income in a single community area. A community-based participatory research approach was employed. Forty-six children and their caregivers were recruited. Children were 5-12 years old with physician-diagnosed asthma and body mass index (BMI) > 85%. Families were offered 12 home visits from CHWs that integrated asthma and obesity core curriculums. The primary asthma outcome was asthma control, measured via the Childhood Asthma Control Test (cACT). The primary obesity outcome was child body mass index (BMI).
  
  
  
  Families received a median of 10 out of the 12 home visits over 1 year. At 1 year, there was a significant improvement in the number of children with controlled asthma as measured via cACT (85.7% at 1 year compared to 61.9% at baseline, p = 0.01). Activity limitations and emergency utilization were reduced while inhaler technique improved (p < 0.01 for all). Child BMI z-score was reduced: mean = 1.97 (SD 0.79) at 1 year compared to mean = 2.13 (SD 0.40) at baseline, p < 0.01. No association was seen between change in child BMI and change in asthma control. Worse baseline child depression scores were associated with less improvement in asthma control (p = 0.003) and higher baseline caregiver post-traumatic stress disorder scores were associated with increased child BMI (p = 0.012).
  
  
  
  The CHW intervention has promise for improving asthma and weight outcomes in high-risk children with comorbid asthma and obesity; this model warrants further development and investigation.
authors.affiliation: University of Illinois at Chicago, 840 South Wood Street, M/C 856, Chicago, IL, 60612, USA. mollyma@uic.edu.
authors.forename: Molly A
authors.initials: MA
authors.lastname: Martin
authors.affiliation: Rush University Medical Center, 1700 W Van Buren, Suite 470, Chicago, IL, 60612, USA.
authors.forename: Steven K
authors.initials: SK
authors.lastname: Rothschild
authors.affiliation: Rush University Medical Center, 1700 W Van Buren, Suite 470, Chicago, IL, 60612, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Lynch
authors.affiliation: Lurie Children's Hospital, 225 E Chicago Ave, Chicago, IL, 60611, USA.
authors.forename: Katherine Kaufer
authors.initials: KK
authors.lastname: Christoffel
authors.affiliation: Puerto Rican Cultural Center, 2700 W Haddon Ave, Chicago, IL, 60622, USA.
authors.forename: Militza M
authors.initials: MM
authors.lastname: Pagán
authors.affiliation: Greater Humboldt Park Community of Wellness, 1116 N. Kedzie, Chicago, IL, 60651, USA.
authors.forename: Jose Luis
authors.initials: JL
authors.lastname: Rodriguez
authors.affiliation: Lurie Children's Hospital, 225 E Chicago Ave, Chicago, IL, 60611, USA.
authors.forename: Anna
authors.initials: A
authors.lastname: Barnes
authors.affiliation: Rush University Medical Center, 1700 W Van Buren, Suite 470, Chicago, IL, 60612, USA.
authors.forename: Kelly
authors.initials: K
authors.lastname: Karavolos
authors.affiliation: University of Illinois at Chicago, Jane Addams College of Social Work, 1040 West Harrison Street, Chicago, IL, 60607, USA.
authors.forename: Antonieta
authors.initials: A
authors.lastname: Diaz
authors.affiliation: Forsyth County Department of Public Health, 201 N Chestnut St, Winston-Salem, NC, USA.
authors.forename: Lucretia M
authors.initials: LM
authors.lastname: Hoffman
authors.affiliation: Rush University Medical Center, College of Medicine, 600 S Paulina St, Chicago, IL, 60612, USA.
authors.forename: Diana
authors.initials: D
authors.lastname: Plata
authors.affiliation: University of Illinois at Chicago, College of Medicine, 808 S Wood St, Chicago, IL, 60612, USA.
authors.forename: Sandra
authors.initials: S
authors.lastname: Villalpando
mesh_terms: D001249:Asthma / Q000150:complications / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D003150:Community Health Workers; D055812:Community-Based Participatory Research; D005240:Feasibility Studies; D005260:Female; D006293:Health Promotion / Q000379:methods; D006699:Home Care Services; D006801:Humans; D008297:Male; D063766:Pediatric Obesity / Q000150:complications / Q000628:therapy*; D012648:Self Care / Q000379:methods; D016896:Treatment Outcome
keywords: Asthma; Community health worker; Obesity; Pediatrics