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Asthma is the most common chronic disease of childhood, affecting 13.8% of U.S. children and resulting in more school days missed than any other disease. Asthma disproportionately affects poor and minority children living in inner-city neighborhoods, and Chicago is demonstrated to be among the hardest hit cities. In some Chicago neighborhoods as many as one in four children has asthma. Nationally, African American and Puerto Rican children have the highest asthma rates documented, with 17% and 26% respectively, ever having received an asthma diagnosis during their lifetime. Not only are African American children at an increased risk of having asthma, but they are more likely to be hospitalized, visit an Emergency Department (ED), or die from asthma than non-Hispanic White children. Furthermore, research in New York City and Boston has documented elevated rates of asthma among residents of federally assisted housing when compared to the general population.
Asthma can be triggered by many things in the home, such as dust mites, mold, cockroaches, pets, chemicals and more. When asthma triggers are reduced or removed and housing appropriately maintained, when medications are properly taken, and doctor visits are regular, asthma is more effectively managed. Controlled asthma thus results in fewer absences from school among children and decreased visits to the ED for asthma attacks.
Helping Children Breathe and Thrive in Chicago’s Public Housing (HCBT) was an asthma initiative at the Sinai Urban Health Institute (SUHI) from 2011 to 2013. It was a partnership between Chicago Housing Authority (CHA), Metropolitan Tenants Organization, Sinai Children’s Hospital and SUHI. Funded by the U.S. Department of Housing and Urban Development, HCBT aimed to improve children’s overall asthma management in Westside CHA developments. This was to be achieved via asthma education, assistance navigating the health care system and thorough home assessments.
The Helping Children Breathe and Thrive in Chicago’s Public Housing (HCBT) project was developed based upon previous asthma interventions implemented at SUHI, mainly the Healthy Home, Healthy Child (HHHC) initiative. HHHC has proven to be an effective model for addressing poorly controlled asthma in the primarily African American, underserved community of North Lawndale. HCBT built upon this model in order to translate it to Chicago Housing Authority (CHA) properties. For additional information on HHHC please click here.
HCBT utilized the Community Health Worker (CHW) model. CHWs from Westside CHA developments served by the project were hired and trained to educate children and their caregivers in their own communities about asthma and how it can be better managed. Although the project was originally slated to focus solely on children with asthma, a high prevalence of adults with asthma was encountered during the recruitment process and thus the project expanded to pilot test the intervention for adults. Children were enrolled in the full year long intervention which included five to six home visits by a CHW, and adults were enrolled in a shortened six month intervention involving three to four home visits. A large component of the home visits included a thorough assessment of the home environment for possible asthma triggers. In the event a trigger was present in the home, CHA was contacted to fix the problem, and education on maintenance was provided to the family by the CHW. Referrals for social issues were also made to FamilyWorks, a case management program with an on-site office at CHA properties. In addition, monthly building education sessions were provided for all residents to attend. Topics were different each month and included: Green Cleaning, Integrated Pest Management, Smoking Cessation, Safety, Nutrition, and more. Those residents who did not have primary care physicians were provided with a list of possible providers, and CHWs facilitated open communication between patients and their doctors. Enrollment in the program was intended to supplement the care the patient receives from his/her physician; it was not intended to be a substitute.
The HCBT project ended in August 2013. Results are very promising, indicating significant reductions in urgent health care utilization, daytime and nighttime asthma symptoms, and home environmental triggers among both children and adults enrolled in the program. Additionally, outcomes revealed statistically and clinically significant improvements in caregiver and adult quality of life. These outcomes all point towards the project’s success in reaching its goal of improving overall asthma management in program participants.
Please click here to read the HCBT final report.
If you would like to learn about SUHI's current HUD funded asthma program, Helping Chicago's Westside Adults Breathe and Thrive, please click here.
For more information about this project please contact Jessica Ramsay at firstname.lastname@example.org