Abstract
BackgroundChildhood asthma is a significant health issue with 8.3% prevalence in the U.S. Its prevalence is particularly higher among low-income communities in the Texas-Mexico border region, as they often lack access to clinical care and health insurance. This study examines the impact of a home-based education led by Community Health Workers (CHWs) on health outcomes for asthmatic, predominantly Hispanic children in these communities.MethodsThe study was a quasi-experimental design to learn the effectiveness of the asthma home-based education by comparing changes of health outcomes between baseline and follow-up of intervention and control groups. This study enrolled 290 participants, consisting of 130 in the intervention group and 160 in the control group. The educational intervention led by the CHWs referenced the Asthma and Healthy Homes curriculum and contents of the Seven Principles of Healthy Homes. The multiple linear regression analysis was conducted to estimate the associations between the intervention and each health outcome.ResultsWhen comparing the intervention group with the control group, the intervention group showed a significantly greater decrease in asthma attacks than the control group (p = 0.049). Although all of the five Children’s Health Survey for Asthma (CHSA) scores showed significant improvements between baseline and follow-up in both groups, we found that increases of CHSA scores in the intervention group were higher than the control group except for emotional health of children (EC) score. The multiple linear regression models demonstrated that the mean changes in asthma attacks (p = 0.036) and emotional health of families (EF) score (p = 0.038) were significantly better in the intervention group than the control group, adjusting for children’s age of diagnosis, household income, use of steroids, family history of allergy, and type of insurance.ConclusionsThis study concluded that the home-based education by CHWs effectively improve health outcomes among children in communities lacking access to medical resources. The findings suggest the importance of the home-based education program in promoting emotional and medical care for children and their families in low-income communities like those in the Texas-Mexico border region.
Highlights
Childhood asthma is a significant health issue with 8.3% prevalence in the U.S Its prevalence is higher among low-income communities in the Texas-Mexico border region, as they often lack access to clinical care and health insurance
Children diagnosed with asthma attending any of the district’s schools were invited to participate in the study, with informed consent obtained from each child’s parent/guardian
The average age of children when diagnosed with asthma was about 3 years old, and slightly more boys than girls participated in the study (55.5%)
Summary
Childhood asthma is a significant health issue with 8.3% prevalence in the U.S Its prevalence is higher among low-income communities in the Texas-Mexico border region, as they often lack access to clinical care and health insurance. The current asthma prevalence for Black (14.1%) and Hispanic children (7.4%) were higher than that of White children (7%) in the U.S [2]. In a 2018 study by Buckner et al, researchers found that asthma is one of the most common chronic diseases among children, causing asthma attacks, school absence, and hospitalizations [3]. Current statistics reveal about 54% of asthmatic children had one or more asthma attacks, nearly half of them miss more than one school day, and about 5% were hospitalized in 2016 [4]. According to a study calculating asthma-related costs, people with asthma had significantly higher total medical expenditures and school or work absences when compared to those without asthma [5]. The estimated total cost of asthma treatment in the U.S, based on a pooled sample of 214,000 patients, was approximately $82 billion in 2013 [5]
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