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Randomized Controlled Trial
. 2009 Nov;99 Suppl 3(Suppl 3):S657-65.
doi: 10.2105/AJPH.2009.165423.

Impact of a household environmental intervention delivered by lay health workers on asthma symptom control in urban, disadvantaged children with asthma

Tyra Bryant-Stephens  1 , Cizely Kurian, Rong Guo, Hauqing Zhao
Affiliations
Randomized Controlled Trial

Impact of a household environmental intervention delivered by lay health workers on asthma symptom control in urban, disadvantaged children with asthma

Tyra Bryant-Stephens et al. Am J Public Health. 2009 Nov.

Abstract

Objectives: We examined whether a home-based educational and environmental intervention delivered by lay health educators would improve asthma symptom control in inner-city children with asthma.

Methods: Children 2 to 16 years of age with diagnosed asthma and at least 1 asthma-related hospitalization or 2 emergency visits in the prior year were randomly assigned into 2 groups (immediate and delayed intervention) in a crossover study. Each group participated in the active phase (intervention) and the inactive phase. Outcomes included asthma symptoms, albuterol use, emergency department visits, hospitalizations, and trigger reduction.

Results: A total of 264 primarily Black (94%) children were enrolled. The mean number of emergency visits decreased by 30% and inpatient visits decreased by 53% (P < .001) after the intervention. Reductions were seen in pests, presence of carpets in bedrooms, and dust. Nighttime wheezing was significantly reduced after the intervention in both groups (P < .001).

Conclusions: Lay health educators effectively reduced asthma triggers and increased caregiver asthma knowledge, which resulted in reduced emergency department visits, hospitalizations, and asthma symptoms. The relationships formed between the caregivers and the lay health educators appeared to positively impact asthma outcomes in this disadvantaged population.

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Figures

FIGURE 1
FIGURE 1
Study design of the asthma environmental mitigation intervention. Note. N1 = immediate intervention group; N2 = delayed intervention group.
See this image and copyright information in PMC

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