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The Seattle-King County Healthy Homes Project: a randomized, controlled trial of a community health worker intervention to decrease exposure to indoor asthma triggers |
Krieger JW, Takaro TK, Song L, Weaver M |
American Journal of Public Health 2005 Apr;95(4):652-659 |
clinical trial |
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
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 to 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 = 0.005) and asthma-related urgent health services use (p = 0.026). Asthma symptom days declined more in the high-intensity group, although the across-group difference did not reach statistical significance (p = 0.138). 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 to 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.
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