Translating a Proven Pediatric Healthy Homes Asthma Intervention to Adults

Abstract

Asthma is a serious public health concern, disproportionately affecting urban, minority populations. Chicago's West and Southwest sides are among the most burdened by asthma and environmental conditions that exacerbate asthma. Home-based, community health worker (CHW)-led interventions have repeatedly demonstrated effectiveness in addressing pediatric asthma. However, evidence of such interventions among adults is limited. Helping Chicago's Westside Adults Breathe and Thrive is a longitudinal cohort study that assesses the effectiveness of a CHW-led asthma and healthy homes intervention for adults. One of the first of its kind, the program aims to improve asthma control and quality of life among adults with poorly controlled asthma. This article provides a framework for implementing the intervention from start to finish. CHWs make five or six home visits over the course of 12 months, providing comprehensive and individualized asthma education to study participants. They work closely with participants to conduct home environmental assessments, collaboratively developing techniques to eliminate or avoid asthma triggers. They also assist with smoking cessation, comorbidities, and health system navigation. Between December 1, 2013, and August 31, 2015, 202 participants enrolled in the program. This article reports on successes, challenges, and recommendations from the program's first 21 months of operation.

A patient advocate to facilitate access and improve communication, care, and outcomes in adults with moderate or severe asthma: Rationale, design, and methods of a randomized controlled trial

“…4–7 Interventions to address access to health care and patient-provider communication have been advocated to eliminate these health disparities. 9 Research is needed to examine the feasibility, acceptability, adaptability, effectiveness, and sustainability of proposed interventions in different settings.…”

“…3 Compared to children, adults are more likely to die from asthma. 1 However, few interventions to improve asthma outcomes have targeted low-income minority adults; 4–7 65% of adults with asthma are women. 1,8 …”

Patient Advocates for Low-Income Adults with Moderate to Severe Asthma: A Randomized Clinical Trial

“…Although there is a growing evidence base of effective asthma control interventions, few have targeted low-income minority adults. [5][6][7] To ensure health equity, the Institute of Medicine advocated addressing access to health care and patient-provider communication by intervening at several levels: the provider-patient interaction, the culture of the practice, the encompassing health system, the community, and the local and national government. 8 We report the evaluation of a patient advocate intervention (PAI) that operates at the first 2 levels of intervention.…”