Advertisement
AJPH
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Figures Only
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow purchase articles
Right arrow View Shopping Cart
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Right arrow Get other permissions
Google Scholar
Right arrow Articles by Bryant-Stephens, T.
Right arrow Articles by Zhao, H.
PubMed
Right arrow PubMed Citation
Right arrow Articles by Bryant-Stephens, T.
Right arrow Articles by Zhao, H.
Related Collections
Right arrow Community Health
Right arrow African Americans/Blacks
Right arrow Other Child and Adolescent Health
Right arrow Asthma
Right arrow Urban Health
November 2009, Vol 99, No. S3 | American Journal of Public Health S657-S665
© 2009 American Public Health Association
DOI: 10.2105/AJPH.2009.165423

RESEARCH AND PRACTICE

Impact of a Household Environmental Intervention Delivered by Lay Health Workers on Asthma Symptom Control in Urban, Disadvantaged Children With Asthma

Tyra Bryant-Stephens, MD, Cizely Kurian, MPh, Rong Guo, MS and Hauqing Zhao, MS

Tyra Bryant-Stephens is with the Department of General Pediatrics and Ambulatory Care, the Children's Hospital of Philadelphia, Philadelphia, PA. Rong Guo and Hauqing Zhao are with the Children's Hospital of Philadelphia–Westat Biostatics and Data Management Core, Philadelphia. At the time of the study, Cizely Kurian was with the Department of Ambulatory Care, the Children's Hospital of Philadelphia, Philadelphia.

Correspondence: Correspondence should be sent to Tyra Bryant-Stephens, The Children's Hospital of Philadelphia Community Asthma Prevention Program, 3535 Market Street Suite 1032, Philadelphia PA, 19104 (e-mail:stephenst{at}mail.chop.edu). Reprints can be ordered at http://www.ajph.org by clicking on the "Reprints/Eprints" link.

Objectives. We examined whether a home-based educational and environmental intervention delivered by lay health educators would improve asthma symptom control in inner-city children with asthma.

Methods. Children 2 to 16 years of age with diagnosed asthma and at least 1 asthma-related hospitalization or 2 emergency visits in the prior year were randomly assigned into 2 groups (immediate and delayed intervention) in a crossover study. Each group participated in the active phase (intervention) and the inactive phase. Outcomes included asthma symptoms, albuterol use, emergency department visits, hospitalizations, and trigger reduction.

Results. A total of 264 primarily Black (94%) children were enrolled. The mean number of emergency visits decreased by 30% and inpatient visits decreased by 53% (P < .001) after the intervention. Reductions were seen in pests, presence of carpets in bedrooms, and dust. Nighttime wheezing was significantly reduced after the intervention in both groups (P < .001).

Conclusions. Lay health educators effectively reduced asthma triggers and increased caregiver asthma knowledge, which resulted in reduced emergency department visits, hospitalizations, and asthma symptoms. The relationships formed between the caregivers and the lay health educators appeared to positively impact asthma outcomes in this disadvantaged population.






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2009 by the American Public Health Association