Home-based Education Research Articles

Evaluating the Feasibility and Acceptability of a Mobile Health-Based Female Community Health Volunteer Program for Hypertension Control in Rural Nepal: Cross-Sectional Study.

BackgroundHypertension is a major modifiable risk factor for cardiovascular disease, the world’s leading cause of death. The prevalence of hypertension is disproportionately higher in South Asian countries than in other regions of the world. Screening for hypertension in primary care settings remains a challenge in many South Asian countries, including Nepal. Nepal is located in the Himalayan Mountains region, posing significant geographical challenges for its rural citizens to access primary health care and service delivery. This barrier increases the costs and inconvenience for rural Nepalis to access hypertension screening and treatment. As a result, the prevalence of hypertension in Nepal tripled in the last 25 years to 22.4%-38.6%. Nepal’s Ministry of Health and Population relies on female community health volunteers to link health centers and communities to provide basic health services. Over 50,000 of these volunteers in Nepal have received basic health care training and are assigned to take care of maternal and child health. Due to limited health care resources, adopting new methods to control hypertension is an urgent need in Nepal. Several recent studies in Nepal have recommended extending the role of female community health volunteers to include hypertension management through blood pressure monitoring and home-based education.ObjectiveThe goal of this study was to assess if a mobile health–based female community health volunteer approach of combining the traditional community health volunteer program with digital technologies would be feasible and acceptable in rural Nepal.MethodsIn this study, we recruited 17 female community health volunteers and extended their role from maternal and child health to hypertension management through screening blood pressures.ResultsAll 17 female community health volunteers successfully measured 1113 rural Nepalis’ blood pressures, identified 169 hypertensive patients, and collected health behaviors data of the 169 hypertensive patients. Among the 169 patients, 70% of them had a mobile phone, and 92% were interested in receiving health-related information via a mobile phone. Among those who were interested in receiving information via a mobile phone, 84% preferred voice calls, and 7% and 1% preferred texting and apps, respectively.ConclusionsResults from this study indicate that a digital health intervention that leverages feature-phones combined with female community health volunteers may be an acceptable and pragmatic way to implement an evidence-based program to reduce hypertension in rural Nepal.

Enhancing Breastfeeding - Home-Based Education on Self-Efficacy: A Preventive Strategy.

Background:The aim of this study is to evaluate the effects of home-based education intervention on the exclusivity and promoting the rates of self-efficacy of breastfeeding.Materials and Methods:A randomized controlled trial was conducted Arak University of Medical Sciences in Takeghani Hospital in Iran between June 2015 and October 2015. A total of 130 eligible and voluntary women hospitalized in Arak University of Medical Sciences Hospital postpartum wards were randomized to receive usual care (n = 65) or education with CD and pamphlets (n = 65). Data regarding exclusive breastfeeding were collected using Denis and Fox's breastfeeding self-efficacy questionnaire. The primary outcome was collected by one assistant researcher during first postpartum visit. The secondary outcome was collected 4 weeks after birth of babies by telephone interviews. Data analysis was performed using descriptive (frequency, mean), independent samples t-test, Student's t-test, t2-test, and Chi-square test. All values of P < 0.05 were considered statistically significant.Results:There was no significant differences between the intervention and control groups with regard to age (P = 0.086) and gestational age (P = 0.741). The breastfeeding self-efficacy scores were higher in the intervention group (63.66 ± 6.11) than in the control group (57.04 ± 6.18) after 1 month of childbirth (P = 0.001). The exclusive breastfeeding rate in intervention group was 89.2 (n = 58) at 1st month after education compared with 55.4% (n = 36) in control group (P = 0.001).Conclusions:In a setting, a high breastfeeding rate and self-efficacy scores were found in education group. Therefore, nurses and midwives are thus required to adopt various health education strategies, such as home education, encourage breastfeeding.

Educação Básica em “xeque”: Homeschooling e fundamentalismo religioso em tempos de neoconservadorismo

This article aims to understand how fundamentalist religious perspectives threaten the concept of Basic Education and, therefore, call into question the ideal of free, compulsory and secular public school, through the defense and regulation of homeschooling in Brazil. The qualitative study of bibliographic and documentary type is transversalized by contributions coming from the epistemological fields of the Sciences of Religion and Education, in order to highlight the ideological strategies undertaken by a religious-fundamentalist and neoconservative activism against rights-related themes, social rights, human rights and school secularity. The analysis indicates that home-based education is rooted in fundamentalist religious values, supported and strengthened by political parties, institutions and religious leaders aligned with the neoconservative movement that is now spreading internationally; and that a possible regulation of homeschooling will jeopardize the subjective public right to Basic Education, this right is ensured after decades of collective struggle for a free, compulsory, equal, inclusive and secular school. Keywords:&nbsp; Basic Education. Homeschooling. Religious fundamentalism. Neoconservatism.

Practical Exploration of Home Study Guidance for Students during the COVID-19 Pandemic: A Case Study of Hangzhou Liuxia Elementary School in Zhejiang Province, China

education model to carry out home-based distance education and student academic counseling, and actively developed teaching practices for home-based learning. We discuss the teaching practice of students’ home study during the pandemic.

Parental involvement in home-based education and children's academic achievement in China

Chinese children's academic achievement has consistently been found to relate to parental involvement. We surveyed 4,222 students in the 8th grade at 15 junior high schools in Hainan Province, China. The data were examined using correlation analysis followed by latent class analysis. The latent class dimensions of parental involvement in home- based education were parent–child communication, home supervision, homework help, emotional support, and parental expectations. A series of models were estimated specifying one through five latent classes. Four types of home-based parental involvement were identified: supportive, basic, strict, and disengaged. After determining the best fitting model, we tested our hypotheses with multiple analysis of variance of parents' socioeconomic status and the students' academic achievement by type of home-based parental involvement. There were, accordingly, significant differences for both socioeconomic status and their children's academic achievement. Scores for both achievement and socioeconomic status were highest among students with supportive home-based parent involvement, followed by those with basic, strict, and disengaged involvement, in descending order. The quantity and quality of parental involvement positively related to the children's academic achievement. We recommend that parents support their children's learning using high-quality communication and involve their children in democratic decision making.

The effect of a home exercise intervention on persons with lower limb amputations: a randomized controlled trial

Objective: To establish if a home-based exercise and education programme is more effective than usual treatment in improving function, mobility and quality of life in people with lower limb amputation due to peripheral vascular disease. Method: A blocked randomized single-blinded controlled trial (RCT) with 154 participants (54 female; mean age 58) compared a home-based exercise and education programme (n = 77) with usual care (control) (n = 77). Participants were measured at baseline, immediately post intervention at three months, and after a further three months without any intervention. The outcome measures were the Barthel Index, Participation Scale, EuroQuol 5D, Modified Locomotor Capability Index and Timed Up and Go Test. Changes over time were established using generalized estimating equations and analysis of covariance, (P < 0.05) Results: The Participation Scale (18.73 ± 14.91 against 26.67 ± 19.14; P = 0.011), the EuroQuol5D visual analogue scale (69.10 ± 20.31 against 55.37 ± 27.67; P = 0.003), EuroQuol5D utility index (0.672 ± 0.300 against 0.532 ± 0.358; P = 0.25) and the Modified Capability Index (21.03 ± 15.79 against 15.91 ± 13.67; P = 0.034) improved in the intervention group compared with the control group at three months. At six months, there was no difference between the groups in any of the measures except for the EuroQuol5D visual analogue scale (74.52 ± 16.14 against 66.34 ± 22.91; P = 0.033). Although there were no differences between the Timed Up and Go test at 3 (35.39 ± 32.48 against 45.08 ± 41.52; P = 0.192) and six months (28.22 ± 20.96 against 36.08 ± 36.19; P = 0.189) between the groups the intervention group was more mobile. Conclusion: This intervention improved function, mobility and quality of life in persons following lower limb amputation in the first three months post amputation.

Patient-Centered Educational Resources for Atrial Fibrillation.

Education has long been recognized as an important component of chronic condition management. Whereas education has been evaluated in atrial fibrillation (AF) populations as part of multifaceted interventions, it has never been tested as a single entity. The aim of this review is to describe the rationale for and role of education as part of comprehensive AF management. The development and use of educational material as part of the intervention of a randomized controlled trial, the HELP-AF (Home-Based Education and Learning Program in AF) study, will be described. This study was designed to determine the impact of a home-based structured educational program on outcomes in individuals with AF. An educational resource was developed to facilitate delivery of 4 key messages targeted at empowering individuals to self-manage their condition. The key messages focused on strategies for managing future AF episodes, the role of pharmacotherapy in the treatment of AF, the appropriate use of medicines to manage stroke risk and the role of cardiovascular risk factor management in AF. To support structured educational visiting, an educational booklet titled Living Well With Atrial Fibrillation (AF) was developed by a multidisciplinary team and was further refined following input from expert clinicians and patient interviews. Using a structured educational visiting approach, education was delivered by trained clinicians within the patient's home.

Male Partner Linkage to Clinic-Based Services for Sexually Transmitted Infections and Human Immunodeficiency Virus Services Following Couple Home-Based Education and Testing

Home-based human immunodeficiency virus (HIV) testing and education has increased HIV test uptake and access to health services among men. We studied how a home-based antenatal intervention influenced male partner utilization of clinic-based HIV and sexually transmitted infection (STI) services, linkage to HIV care and medical circumcision. We conducted a secondary analysis within a randomized controlled trial of pregnant women attending antenatal care in Kenya. Women and their male partners received either a home-based couple intervention or an invitation letter for clinic-based couple HIV testing. The home-based intervention included education on STI symptoms, STI and HIV treatment and male circumcision for HIV prevention. Male self-reported outcomes were compared using relative risks at 6 months postpartum. Among 525 women, we reached 487 (93%) of their male partners; 247 men in the intervention arm and 240 men in the control arm. Men who received the intervention were more likely to report an STI consultation (n = 47 vs. 16; relative risk, 1.59; 95% confidence interval, 1.33-1.89). Among 23 men with newly diagnosed HIV, linkage to HIV care was reported by 4 of 15 in the intervention (3 men had missing linkage data) and 3 of 5 men in the control arms (relative risk, 0.66; 95% confidence interval, 0.34-1.29). Although the intervention identified 3 times more men with new HIV infection, the study lacked power to find significant differences in linkage to HIV care. Few eligible men sought medical circumcision (4 of 72 intervention and 2 of 88 control). Home-based couple education and testing increased STI consultations among male partners of pregnant women, but appeared insufficient to overcome the barriers involved in linkage to HIV care and medical circumcision.

Uzbekistan: Case for Inclusion

The inclusion of children with disabilities in mainstream education has become an important agenda for many developing countries. The Uzbekistan government has also attempted to provide equal educational opportunities to this previously excluded group of children. Despite these efforts, however, many children with disabilities remain segregated. The total number of children with disabilities under 16 years old in the country is 97,000 (Uzbek Society of Disabled People, 2014). The majority of them either study at specialised educational institutions, or receive home-based education. Those who are placed at specialised institutions are often deprived of resources and services necessary to receive adequate education (UNICEF, 2013). While limited by the lack of reliable empirical data and research, this article aims to present the current situation in the development of inclusive education in Uzbekistan. It outlines the major legislative documents intended to support inclusive education and identifies some of the current obstacles to inclusive education practices.

Effects of the home-based educational intervention on health outcomes among primarily Hispanic children with asthma: a quasi-experimental study

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.

Home-Based Education and Learning Program for Atrial Fibrillation: Rationale and Design of the HELP-AF Study

BackgroundAtrial fibrillation (AF) is a growing global epidemic, with its prevalence expected to significantly rise over coming decades. AF poses a substantial burden on health care systems, largely due to hospitalizations. Home-based clinical characterization has demonstrated improved outcomes in cardiac populations, but its impact on AF remains poorly defined. To test this hypothesis in AF, we developed the Home-Based Education and Learning Program for Patients With Atrial Fibrillation (HELP-AF) study. MethodsThe HELP-AF study is a prospective multicentre randomized controlled trial that will recruit 620 patients presenting to hospital emergency departments (EDs) with symptomatic AF (ANZCTR Registration: ACTRN12611000607976). Patients will be randomized to either the HELP-AF intervention or usual care. The intervention consists of 2 home visits by a nurse or pharmacist trained in the structured educational visiting (SEV) method. Patients in the control group will receive usual discharge follow-up care. ResultsThe primary endpoints are total unplanned hospital admissions and quality of life. Secondary endpoints include AF symptom severity and burden score; time to first hospital admission; total unplanned days in hospital; total AF-related hospital admissions (including atrial flutter); total cardiac and noncardiac hospital admissions; total AF- or atrial flutter-related; cardiac- and noncardiac-related ED presentations; and all-cause mortality. An economic evaluation will also be performed. Clinical endpoints will be adjudicated by independent blinded assessors. Follow-up will be at 24 months. ConclusionsThis study will assess the efficacy of a home-based structured patient-centred educational intervention in patients with AF.

Cost-effectiveness of a home-based group educational programme on renal replacement therapies: a study protocol

IntroductionLiving donor kidney transplantation (LDKT) is the optimal treatment for most patients with end-stage renal disease (ESRD). However, there are numerous patients who cannot find a living kidney donor. Randomised...

Korepetytor w nauczaniu domowym na ziemiach polskich doby zaborów

Despite recent research on home-based education and teaching of children in the eighteenth and the nineteenth centuries, the subject of home and private tutors has yet not been properly addressed. Though there are more or less extensive mentions on the subject in question in articles devoted to home tutors or home tutelage, they do not, however, delve deeper into the investigation of the problem. Therefore, the present work attempts to characterize this position of appointed, or hired, teachers who were involved in the process of education of children in Polish families in time of partitions. The main problem is approached from the two following perspectives – the aim of the article is to: 1) indicate more precisely the status of private tutors, their social background, goals to be attained by them, their duties, responsibilities and conditions of work, i.e. a determination of their real participation in the education of children from Polish families during the time under scrutiny; and also 2) to show the contemporary standpoint expressed by the then educational columnists and journalists on the very idea of private tutoring and private tutors, as well as their postulates, recommendations to be followed and advice concerning hired teaching staff. The source material for the present analysis of the capacity and function of private tutors has been provided by relevant educational literature for professionals and parents written in the nineteenth century and the beginning of the twentieth century, professional educational periodicals and women’s and family magazines of the time. The source materials provide an excellent base for a determination of the extent and the scope of the interest of the contemporary columnists and journalists in this group of private tutors and private tutelage at the time, but also present the attitude towards the phenomenon manifested by the general public. The analysis is supplemented with additional material excerpted from contemporary memoirs and diaries that serve here as a useful illustration of the reality and practice in the actual teaching process of appointed tutors in the times of national freedom struggle in Poland.

Randomised controlled trial of a video intervention and behaviour contract to improve medication adherence after renal transplantation: the VECTOR study protocol

IntroductionNon-adherence after kidney transplantation contributes to increased rejections, hospitalisations and healthcare expenditures. Although effective adherence interventions are sorely needed, increasing education and support to transplant recipients demands greater use of...

Primary Care and Food Bank Collaboration to Address Food Insecurity: A Pilot Randomized Trial.

Food insecurity is common in the United States and linked to poor control of conditions influenced by diet. We conducted a pilot randomized trial to test whether a novel partnership between a primary care practice and a municipal food bank would improve control of type 2 diabetes among patients with food insecurity. Participants received food bank produce delivered twice monthly to the practice site, brief teaching from a food bank dietitian, and home-based education from a community health worker. After 6 months, glycosylated hemoglobin decreased (absolute change) by 3.1% in the intervention group vs 1.7% in the control group (P = .012). Scores on Starting the Conversation–Diet, a brief dietary measure, improved in the intervention group by 2.47 on a 14-point scale (P < .001). Body mass indexes (BMIs) were unchanged. In this early-stage study, onsite collaboration between primary care and a regional food bank generated clinically meaningful reductions in HbA1c and improvements in diet.

The Influence of a Home-Based Education Intervention on Family Caregivers’ Knowledge and Self-Efficacy for Cancer Pain Management in Adult Patients Within a Resource-Limited Setting

Cancer-related pain is prevalent and has debilitating effects on patients and their family. The effects of cancer pain can be curtailed if the family members caring for the patient receive essential support to enhance their capabilities for cancer pain management. Little has been done to study the available support to family caregivers (FCGs) towards pain management in adult cancer patients (ACPs) living in resource-limited countries where the burden of cancer is on the rise. This study evaluated the influence of an education intervention delivered in the home setting on FCGs' knowledge and self-efficacy (SE) for pain management in ACPs. One-group pre-/post-test design was used in a sample of 54 FCGs who had been caring for ACPs suffering from pain for at least 1month. Data were collected using the Family Pain Questionnaire and Caregiver Pain Management SE Scale. The FCGs' mean knowledge score post-intervention (26.69 ± 10) was higher than the baseline (45 ± 12.9), and the difference was statistically significant (t = 10.382, p = 0.000, CI = 17.12-25.43). Additionally, the FCGs' mean SE score post-intervention (1003.30 ± 191) was higher than the baseline (648.3 ± 273.4), and the difference was statistically significant (t = - 8.52, p = 0.000, CI = - 438.6-- 271.4). The home-based education intervention significantly and positively influenced the FCGs' knowledge and SE for pain management while at home. Cancer pain management educational interventions delivered at home should be considered as one of the strategies for enhancing cancer care in resource limited settings.

Effects of home-based physical activity incitation and education program in subacute phase of stroke recovery after 6 months of monitoring

The aim of the study was to evaluate the effect of physical activity incitation and education program at home on functional capacity, fatigue and depression levels in subacute phase of stroke recovery. Eighty-four volunteers post-stroke patients participated in this randomized clinical trial (Mean ± SD; Age: 62 ± 13 years; Barthel Index: 95.4 ± 9.1; Weight: 76.8 ± 15 Kg; Stroke delay: 77.6 ± 45.7 days). Participants were divided into a Home-based Physical Activity Incitation group (HBPAI, n = 42) and Control group (CG, n = 42). HBPAI follow the physical activity incitation program during six months. The 6 minutes walking test (6MWT), Functional Ambulation Classification (FAC), Hospital Anxiety Depression Scale (HADS) and Multidimensional Fatigue Inventory questionnaire (MFI-20) were measured at baseline (T0), after 6 months (T1) and 12 months (T2). 6MWT (m) performed by HBPAI and CG group at T0, T1 and T2 was (374 ± 141.1; 454 ± 134.8; 437.8 ± 146.4) and (372.5 ± 149.4; 385 ± 157.8; 400.1 ± 153) respectively. Distance walked during 6MWT significantly increased in HBPAI than CG ( P < 0.05) at T1, but not at T2. Score of general fatigue significantly decreased between T0 and T1 (11.9 ± 3.1 and 10.5 ± 2.9; P < 0.004) and T2 (9.6 ± 4.1; P < 0.001) in HBPAI. Depression score significantly decreased between T0 and T2 (8.6 ± 3.2 and 6.5 ± 3.7; P < 0.01) in HBPAI. Increasing physical activity after stroke could improve post-stroke common functional problems. However, the efficacy of physical activity programs at home is still unknown (Jones et al., 2015). Furthermore, there is limited information about the effects of PA on fatigue levels after stroke (Duncan et al., 2012). HBPAI program could be a good strategy to improve the walking distance and decrease fatigue and depression scores in subacute phase of stroke recovery.

Health Disparity in Diabetes Care—Impact of Community Health Representative–Led Patient Activation and Engagement

Objective: To compare the impact of home-based care and education delivered by community health representatives (CHRs) as part of a clinical care team vs. usual clinic-based care on measures of patient activation and risk factors for diabetes in adult Zuni Indians. Methods: We conducted a pilot randomized controlled trial of a home-based intervention vs. usual clinic care provided by the local Zuni Indian Health Service (IHS). The study’s primary outcome was patient activation, assessed by the Patient Activation Measure (PAM). We screened 315 Zuni adults and enrolled and randomized 125 Zuni adults into the study. We used linear and logistic regression with generalized estimating equations to compare changes in the outcomes of interest over time between the two study groups. Results: Compared to those receiving usual care at IHS, Zuni adults in the intervention group experienced significantly greater improvement in the patient activation measure, quality of life, and in several clinical measures of risk factors for diabetes at 12 months. Participants in the intervention increased their PAM total scores, on average, by 8.6 points more than participants randomized to usual care (p=0.023). BMI in the intervention group decreased by 1.kg/m2 more than was observed in the control group (p=0.007). Hemoglobin A1C levels in the intervention group decreased by 8% more than in the control group (p=0.022). The hs-CRP levels in the intervention group decreased by 62% more than in the control group (p&amp;lt;0.001). Discussion: Delivering culturally appropriate home-based care and education by CHRs is a promising approach for improving disease-specific knowledge, confidence, and self-management skills among rural minority populations at high risk for diabetes who experience barriers to accessing health care. Disclosure V. Shah: None. V.S. Pankratz: None. D.M. Ghahate: None. J. Bobelu: None. R. Nelson: None.

Diabetes management training for female community health volunteers in Western Nepal: an implementation experience

BackgroundIn the backdroup of a rapidly increasing burden of diabetes in Nepal, a community-based diabetes management program is implemented involving female community health volunteers (FCHVs) under the government run FCHVs program. FCHVs received an intensive one-week training workshop on prevention, control and management of diabetes. The training program was implemented and evaluated to enhance diabetes knowledge of FCHVs and matched according to their literacy level.MethodsA range of teaching methods were applied, including desk review, active participation, lectures, presentations, discussions, role plays, demonstration and field test. Evaluation of the knowledge attained was done by testing before and after the workshop. Major milestones in the development of the training module were presented from desk review and ending in stakeholder’s participation in reviewing and revising the training package. The qualitative interview transcripts of FCHVs were analyzed thematically.ResultsA 5-day training package was developed through a desk review of interventions using community health workers (CHWs) on diabetes management from similar settings. Training module included home-based blood glucose monitoring and home-based health education on life style counselling delivered through a participatory learning approach. There were 20 participants with a mean age of 47 years (SD ± 5.7). The overall assessment of knowledge of diabetes before-after the training, evaluated by the Diabetes Knowledge Questionnaire (DKQ) showed increases in mean score from 40.4% before training to a mean score of 63.3% after training (Paired t-test: t = − 11.1, P < 0.001, and Wilcoxon test for paired samples: z = − 3.930, P = 0.0001). Focus group discussions (FGDs) revealed that FCHVs had a favorable perception of the training program’s effectiveness.ConclusionsIf FCHVs are appropriately trained they may be instrumental in providing counseling and screening for diabetes management in their communities.

Outcomes of the Montana Asthma Home Visiting Program: A home-based asthma education program

ABSTRACTObjective: Asthma is a common disease in children. Home-based, multi-trigger, multi-component interventions with an environmental focus have been shown to be effective to address asthma in children. The objective of this study was to assess the outcomes and feasibility of implementing a specific asthma home visiting (HV) program in a rural area. Methods: Children aged 0–17 years with uncontrolled asthma were enrolled in an asthma HV program that included six contacts over a 12-month period delivered by a registered nurse specifically trained in asthma education and trigger removal in eleven counties in the rural state of Montana. Between June 2010 and December 2016, data on asthma symptoms and asthma self-management skills were collected at baseline and throughout the program. In June 2017, they were analyzed to assess changes in asthma control and quality of life over time among participants completing all six contacts. Results: Since June 2010, 152 of 338 enrolled children completed all six contacts outlined in the program (45%). Participants who completed the program reported significant improvements in asthma control test scores, self-management skills, and self-efficacy related to asthma management. These results improved the longer participants remained in the program. Conclusions: These findings suggest that it is feasible to implement a 12-month HV program using local public health resources in a rural area as outcomes improved over this time period.