The Seattle-King County healthy homes project: implementation of a comprehensive approach to improving indoor environmental quality for low-income children with asthma.
The Seattle-King County healthy homes project: implementation of a comprehensive approach to improving indoor environmental quality for low-income children with asthma.
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DOI：
10.1289/ehp.02110s2311
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发表时间：
2002-04
影响因子：
10.4
通讯作者：
Dickey, Phillip
中科院分区：
文献类型：
--
作者：
Krieger, James K;Takaro, Tim K;Allen, Carol;Song, Lin;Weaver, Marcia;Chai, Sanders;Dickey, Phillip
儿童哮喘是一个日益严重的公共卫生问题，不成比例地影响低收入人群和有色人种。暴露于室内哮喘触发物在哮喘的发展和加重中起重要作用。我们描述了西雅图国王县健康家园项目的实施，这是一项随机对照试验，通过减少家中过敏原和刺激物的暴露，进行外展/教育干预，改善哮喘相关的健康状况。我们将274名4-12岁的低收入哮喘儿童随机分配到高强度或低强度组。在高强度组中，社区卫生工作者称为社区家庭环境专家（CHES），他们进行了初步的家庭环境评估，提供了个性化的行动计划，并在12个月内进行了额外的访问，以提供教育和社会支持，鼓励参与者采取行动，提供减少暴露的材料（包括床上用品）、协助消灭蟑螂和啮齿动物以及倡导改善住房条件。低强度组的成员接受了初步评估，家庭行动计划，评估访问期间的有限教育和床上用品。我们描述了CHES的招募和培训以及他们面临的挑战，并解释了针对尘螨、霉菌、烟草烟雾、宠物、蟑螂、啮齿动物、灰尘、水分和有毒或危险化学品的评估和暴露减少方案。我们还讨论了文献中推荐的做法与国内可行的做法之间的差距。我们完成了家庭干预，参与者发现该项目非常有用。该项目在解决导致暴露于室内触发因素的结构性住房质量问题方面受到限制。
Pediatric asthma is a growing public health issue, disproportionately affecting low-income people and people of color. Exposure to indoor asthma triggers plays an important role in the development and exacerbation of asthma. We describe the implementation of the Seattle-King County Healthy Homes Project, a randomized, controlled trial of an outreach/education intervention to improve asthma-related health status by reducing exposure to allergens and irritants in the home. We randomly assigned 274 low-income children with asthma ages 4-12 to either a high- or a low-intensity group. In the high-intensity group, community health workers called Community Home Environmental Specialists (CHES) conducted initial home environmental assessments, provided individualized action plans, and made additional visits over a 12-month period to provide education and social support, encouragement of participant actions, provision of materials to reduce exposures (including bedding encasements), assistance with roach and rodent eradication, and advocacy for improved housing conditions. Members of the low-intensity group received the initial assessment, home action plan, limited education during the assessment visit, and bedding encasements. We describe the recruitment and training of CHES and challenges they faced and explain the assessment and exposure reduction protocols addressing dust mites, mold, tobacco smoke, pets, cockroaches, rodents, dust, moisture, and toxic or hazardous chemicals. We also discuss the gap between the practices recommended in the literature and what is feasible in the home. We accomplished home interventions and participants found the project very useful. The project was limited in resolving structural housing quality issues that contributed to exposure to indoor triggers.