Sustainability of residential environmental interventions and health outcomes in the elderly

David A Turcotte,Emily Chaves,Kelechi L Adejumo,Rebecca Gore,Kim-Judy You,Susan Woskie

doi:10.1186/s40733-020-00066-6

David A Turcotte, Emily Chaves + Show 4 more

Open Access

https://doi.org/10.1186/s40733-020-00066-6

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Abstract

BackgroundResearch has documented that housing conditions can negatively impact the health of residents. Asthma has many known indoor environmental triggers including dust, pests, smoke and mold, as evidenced by the 25 million people in the U.S. population who have asthma. The paper describes a follow-up study involving elder adults with asthma who participated in a multifaceted home educational and environmental intervention shown to produce significant health benefits. On average the time between the end of the prior intervention study and the follow-up was 2.3 years. The objective of this study was to evaluate whether improvements in environmental conditions and health outcomes resulting from the original Older Adult Study (OAS, multifaceted educational and environmental interventions) would be maintained or decline over time for these low income seniors with asthma.MethodsHealth assessment included data on respiratory health outcomes included the Saint George’s Respiratory Questionnaire (SGRQ) and Asthma Control Test from the original Older Adult Study (OAS) and this follow-up Older Adult Study (OAFS) along with health care utilization data. Environmental assessments included evaluation of asthma trigger activities (ATAs) and exposures before and after the original healthy homes intervention (questionnaire, home survey) and at this follow-up. Assessments were conducted in English, Khmer and Spanish.ResultsAt assessment in the Older Adult Follow-up Study (OAFS), the older adults maintained some of the health improvements gained during the OAS when compared to the OAS pre-intervention baseline. However, health outcomes declined from the OAS final assessment to the OAFS (only the SGRQ Impact scores were significantly different).ConclusionThese findings suggest that further study with a larger population is needed to determine if the significant health outcome improvements from multifaceted home educational and environmental interventions (OAS) could be more strongly maintained by providing additional follow-up “booster” interventions to this older adult population with asthma.

Highlights

Research has documented that housing conditions can negatively impact the health of residents
In the original Older Adult Study (OAS) study [20], we found statistically significant improvements in self-reported environmental asthma triggers and health outcomes in the number of doctor visits, uses of antibiotics for chest illness, Asthma Control Test (ACT) scores, Saint George’s Respiratory Questionnaire (SGRQ) respiratory symptoms and quality of life indicators
In the original OAS study [20] we found a significant improvement from the baseline to the final assessment for a number of outcomes We found significant improvements in the asthma symptoms that make up the SGRQ

Summary

Introduction

Research has documented that housing conditions can negatively impact the health of residents. Asthma has many known indoor environmental triggers including dust, pests, smoke and mold, as evidenced by the 25 million people in the U.S population who have asthma. The paper describes a follow-up study involving elder adults with asthma who participated in a multifaceted home educational and environmental intervention shown to produce significant health benefits. The objective of this study was to evaluate whether improvements in environmental conditions and health outcomes resulting from the original Older Adult Study (OAS, multifaceted educational and environmental interventions) would be maintained or decline over time for these low income seniors with asthma. In the United States over 19.2 million adults suffer from asthma [2]. Asthma is linked to many known indoor environmental triggers including dust, pests, smoke and pets. Older adults 65+ are recognized as a population that is more sensitive to poor indoor air quality [5] and older persons spend up to 90% of their time indoors, often at home [4]

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