December 12th, 2017
The effectiveness of community health workers (CHWs) assisting families in reducing exposure to indoor asthma triggers has not been studied. In all, 274 low-income asthmatic children were randomly assigned to high- or low-intensity groups. CHWs visited all homes to assess exposures, develop action plans and provide bedding encasements. The higher-intensity group also received cleaning equipment and five to nine visits over a year focusing on asthma trigger reduction. The asthma trigger composite score decreased from 1.56 to 1.19 (D_{0.37, 95% CI 0.13, 0.61) in the higher-intensity group and from 1.63 to 1.43 in the low-intensity group (D_{0.20, 95% CI 0.004, 0.4). The difference in this measure due to the intervention was significant at the P_0.096 level. The higher-intensity group also showed improvement during the intervention year in measurements of condensation, roaches, moisture, cleaning behavior, dust weight, dust mite antigen, and total antigens above a cut point, effects not demonstrated in the low-intensity group. CHWs are effective in reducing asthma trigger exposure in low-income children. Further research is needed to determine the effectiveness of specific interventions and structural improvements on asthma trigger exposure and health. Journal of ExposureAnalysis and Environmental Epidemiology (2004) 14, S133–S143. doi:10.1038/sj.jea.7500367 Keywords: asthma, indoor environment, antigen exposure, interventions, community health workers, Healthy Homes, inner city.