Abstract
Pediatric asthma morbidity is often linked to challenges including poor housing quality, inability to access proper medical care, lack of medications, and poor adherence to medical regimens. Such factors also propagate known disparities, by race and income, in asthma-related outcomes. Multimodal home visits have an established evidence base in support of their use to improve such outcomes. The Collaboration to Lessen Environmental Asthma Risks (CLEAR) is a partnership between the Cincinnati Children’s Hospital Medical Center and the local health department which carries out home visits to provide healthy homes education and write orders for remediation should code violations and environmental asthma triggers be identified. To assess the strengths and weaknesses of the program, we obtained qualitative feedback from health professionals and mothers of children recently hospitalized with asthma using key informant interviews. Health professionals viewed the program as a positive support system for families and highlighted the potential benefit of education on home asthma triggers and connecting families with services for home improvements. Mothers report working to correct asthma triggers in the home based on the education they received during the course of their child’s recent illness. Some mothers indicated mistrust of the health department staff completing home visits, indicating a further need for research to identify the sources of this mistrust. Overall, the interviews provided insights into successful areas of the program and areas for program improvement.
Highlights
Asthma is among the most common chronic diseases in children [1]
This study focused on an evaluation of an asthma home environmental intervention program, Collaboration to Lessen Environmental Asthma Risks (CLEAR)
The current study indicated that it will be necessary to find ways to reach and involve families in home visits, reduce fears of repercussions, and ensure caregivers feel comfortable accessing sanitarians at health departments
Summary
Asthma is among the most common chronic diseases in children [1]. Asthma affects approximately seven million children in the United States (U.S.) with annual asthma-related healthcare expenditures of USD 56 billion. This high cost is primarily associated with emergency department (ED) visits and hospitalizations [2]. Utilization of acute services for asthma complications occurs at disproportionately high rates among minority and low-income children living in more urban areas [2]. Black children experience nearly twice as many ED visits and hospitalizations for asthma, and experience four times more asthma-related deaths when compared to White children [4]
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