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The Seattle-King County Healthy Homes Project

An Evidence-Based Practice

Description

The Healthy Homes model of reducing household allergens and respiratory irritants employs trained community health workers to conduct home environmental assessments, identify exposures and train people how to take low-cost actions in their home to reduce exposures. Exposure and sensitization to allergens and irritants found in the household environment are major factors in the development and exacerbation of asthma. Interventions that address household triggers of asthma must be undertaken in order to reduce the increasing level of morbidity in the United States due to childhood asthma.

In the Healthy Homes project implemented in Seattle and King County Washington, community health workers called Community Home Environmental Specialists (CHES) conducted initial home environmental assessments of project participants' households. After the assessment, the CHES provided an individualized action plan for the household. Participants were provided with bedding covers, vacuums and cleaning supplies and were taught how to clean in order to keep dust mites, rodents and other allergens at a minimum. The CHES made additional visits over a 12-month period to provide education and social support. The CHES helped project participants understand asthma and asthma self-management using the "natural helper" model of community education.

Goal / Mission

The goals of the Seattle-King Healthy Homes project are: to increase knowledge of home environmental health threats and asthma self-management among households with a child who suffers from asthma; help households reduce environmental threats in the household; improve health status and reduce asthma-related medical care utilization.

Results / Accomplishments

A randomized-controlled trial was conducted to determine the effectiveness of the Healthy Homes model. The study compared a group of participants who received the full, high-intensity intervention to a group of households who received a single visit by a CHES. The group who participated in the full program improved significantly more than the other group in its pediatric asthma caregiver quality-of-life score (P=0.005) and asthma-related urgent health services use (P=0.026). The number of days the child experienced asthma symptoms declined more among household who received the more intense intervention. Participant actions to reduce triggers generally increased in the high-intensity group. The authors of this study projected the 4-year net savings per participant among the high-intensity group relative to the low-intensity group were between 189-721 US dollars. The National Institute of Environmental Health Sciences, the Department of Housing and Urban Development and the Environmental Protection Agency have recognized the potential of the Healthy Homes approach to reduce environmental asthma triggers.

About this Promising Practice

Organization(s)
King County Asthma Forum
Primary Contact
James Krieger, MD, MPH
Public Health - Seattle & King County
Chief, Epidemiology, Planning and Evaluation
(206) 263-8688
James.Krieger@kingcounty.gov
http://www.kingcounty.gov/healthservices/health/ch...
Topics
Health / Respiratory Diseases
Health / Children's Health
Organization(s)
King County Asthma Forum
Source
National Institutes of Environmental Health Sciences
Date of publication
2005
Location
Seattle-King County, Washington
For more details
Target Audience
Children, Families