The Seattle-King County Healthy Homes Project: A randomized, controlled trial of a community health worker intervention to decrease exposure to indoor asthma triggers
The Seattle-King County Healthy Homes Project: A randomized, controlled trial of a community health worker intervention to decrease exposure to indoor asthma triggers
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DOI：
10.2105/ajph.2004.042994
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发表时间：
2005-04-01
影响因子：
12.7
通讯作者：
Weaver, M
中科院分区：
文献类型：
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作者：
Krieger, JW;Takaro, TK;Weaver, M
目标.我们评估了社区卫生工作者干预措施的有效性，重点是减少接触室内哮喘诱因。方法。我们在274个低收入家庭中进行了一项随机对照试验，随访1年，其中包括一名4-12岁患有哮喘的儿童。社区卫生工作者提供家庭环境评估、教育、行为改变支持和资源。参与者被分配到接受7次访问和全套资源的高强度组或接受单次访问和有限资源的低强度组。高强度组在儿童哮喘护理者生活质量评分（P= 0.005）和哮喘相关紧急卫生服务使用（P= 0.026）方面的改善显著高于低强度组。高强度组的哮喘症状天数下降更多，尽管组间差异未达到统计学显著性（P= 0.138）。参与者减少触发因素的行动在高强度组中普遍增加。相对于低强度组，高强度组每个参与者的预计4年净储蓄为189 - 721美元。社区卫生工作者减少了哮喘症状天数和紧急卫生服务的使用，同时改善了照顾者的生活质量评分。更高强度的干预改善更大。
Objectives. We assessed the effectiveness of a community health worker intervention focused on reducing exposure to indoor asthma triggers.Methods. We conducted a randomized controlled trial with 1-year follow-up among 274 low-income households containing a child aged 4-12 years who had asthma. Community health workers provided in-home environmental assessments, education, support for behavior change, and resources. Participants were assigned to either a high-intensity group receiving 7 visits and a full set of resources or a low-intensity group receiving a single visit and limited resources.Results. The high-intensity group improved significantly more than the low-intensity group in its pediatric asthma caregiver quality-of-life score (P=.005) and asthma-related urgent health services use (P=.026). Asthma symptom days declined more in the high-intensity group, although the across-group difference did not reach statistical significance (P=.138). Participant actions to reduce triggers generally increased in the high-intensity group. The projected 4-year net savings per participant among the high-intensity group relative to the low-intensity group were $189-$721.Conclusions. Community health workers reduced asthma symptom days and urgent health services use while improving caregiver quality-of-life score. Improvement was greater with a higher-intensity intervention.