A Community-Based Intervention to Reduce Environmental Triggers for Asthma Among Children: The primary goal of this proposed community-based intervention research project is to reduce exposure of children to environmental contaminants within their homes and neighborhoods that trigger asthma, thereby improving asthma-related health status and reducing asthma-related medical care utilization.
The first aim i s to implement a comprehensive intervention at the household and neighborhood level to reduce exposure to indoor and outdoor environmental health hazards associated with asthma for children. Asthmatic children will be identified through elementary school screenings and their parents will be asked to enroll in a household intervention in which outreach workers will visit each household 12 times in two years (9 times in the intensive first year, 3 times in the second year). Outreach workers will work with the family to reduce indoor household exposure factors identified as exacerbating asthma, such as cockroach allergens, cat dander, environmental tobacco smoke, and mold.
The second aim i s to conduct a randomized, staggered design community-based intervention to test the following hypotheses. a) The household level intervention will improve asthma-related health status (and other mental and physical health outcomes), and increase behaviors to reduce home environmental hazards. (450 households will be enrolled, with 225 households receiving the intervention in the first year and 225 receiving the intervention in the 2nd year). 2) A neighborhood level intervention when combined with a household level intervention will provide an enhanced effect on the outcomes at the household level. c) A less intensive household intervention following an initial intensive intervention will maintain similar level effects. d) A long-term neighborhood intervention, when combined with a household level intervention, will result in greater intervention effects than a household level intervention with a short-term neighborhood component.
The third aim i s to conduct a process and context evaluation of both components of the intervention.
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