Abstract
Research on asthma frequently recruits patients from clinics because the ready pool of patients leads to easy access to patients in office waiting areas, emergency departments, or hospital wards. Patients with other chronic conditions, and with mobility problems, face exposures at home that are not easily identified at the clinic. In this article, we describe the perspective of the community health workers and the challenges they encountered when making home visits while implementing a research intervention in a cohort of low-income, minority patients. From their observations, poor housing, often the result of poverty and lack of social resources, is the real elephant in the chronic asthma room. To achieve a goal of reduced asthma morbidity and mortality will require a first-hand understanding of the real-world social and economic barriers to optimal asthma management and the solutions to those barriers.
Highlights
Research on asthma frequently recruits patients from clinics because the ready pool of patients leads to easy access to patients in office waiting areas, emergency departments, or hospital wards
Most often we focus on recognized patient-level predictors of frequent emergency department use, which potentially can be addressed in the health care setting, such as suboptimal self-management, limited or inadequate health insurance, and underlying severity of asthma.[6]
Clinical research has given us evidence-based recommendations to improve asthma control, but disparities will continue to persist until there are solutions to the impact of socioeconomic factors on health
Summary
Tyra Bryant-Stephens, MD,a,b Shakira Reed-Wells, CHW,a Maryori Canales, CHW,a Luzmercy Perez, BA,b,c Marisa Rogers, MD,b A. We describe the perspective of the community health workers and the challenges they encountered when making home visits while implementing a research intervention in a cohort of low-income, minority patients From their observations, poor housing, often the result of poverty and lack of social resources, is the real elephant in the chronic asthma room. Only 30% of the clinicians relate regularly helping patients make decisions about asthma management and only 33% of the clinicians reported consistently tailoring medication schedules to the patient’s routines Leaving these needs unaddressed creates barriers for optimal health management for the sickest people with asthma.[8] Home visits by researchers will allow consideration of these barriers in research protocols and provide insight for practicing clinicians. Residents are exposed to common indoor asthma triggers such as rodents, roaches, and mold
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