CDC COMMUNITY GUIDE: Asthma Control: Home-Based Multi-Trigger, Multicomponent Environmental Interventions

CDC

An Evidence-Based Practice

Description

Home-based multi-trigger, multicomponent interventions with an environmental focus for persons with asthma aim to reduce exposure to multiple indoor asthma triggers (allergens and irritants). These interventions involve home visits by trained personnel to conduct two or more activities. The programs in this review conducted environmental activities that included:
• Assessment of the home environment
• Changing the indoor home environment to reduce exposure to asthma triggers
• Education about the home environment

Most programs also included one or more of the following additional non- environmental activities
• Training and education to improve asthma self-management
• General asthma education
• Social services and support
• Coordinated care for the asthma client

The Community Preventive Services Task Force recommends the use of home-based multi-trigger, multicomponent interventions with an environmental focus for children and adolescents with asthma based on evidence of effectiveness in improving overall quality of life and productivity, specifically:
• Improving asthma symptoms
• Reducing the number of school days missed due to asthma

Goal / Mission

To improve overall quality of life and productivity for children and adolescents that suffer from asthma.

Impact

Home-based multi-trigger, multi-component interventions with a combination of minor or moderate environmental remediation with an education component provide good value based on improvement in symptoms free days.

Results / Accomplishments

Results from the Systematic Reviews:
Twenty-three studies qualified for the effectiveness review.

Among children and adolescents:
• Asthma symptom days: median decrease of 21 days per year (6 studies)
• School days missed: median decrease of 12 days per year (5 studies)
• Acute healthcare visits: combined median decrease of 0.57 visits per year (10 studies)
• Hospitalizations: median decrease of 0.4 hospitalizations per year
• Emergency department visits: median decrease of 0.2 visits per year
• Unscheduled office visits: median decrease of 0.5 visits per year
• Pulmonary function: overall, no significant improvement (7 studies)

About this Promising Practice

Primary Contact
communityguide@cdc.gov
Topics
Health / Respiratory Diseases
Source
Community Guide Branch Epidemiology and Analysis Program Office, Centers for Disease Control and Prevention
Location
USA
For more details
http://www.thecommunityguide.org/index.html
http://www.thecommunityguide.org/asthma/multicompo...
Target Audience
Children, Teens

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An Evidence-Based Practice meets the following HCI criteria:

  1. The program description includes at a minimum: the sponsoring organization, program goals, program implementation steps, and outcomes that have demonstrated program success in achieving the program goal in one or more localities.
  2. The results from an evaluation of the program include quantitative measures showing improvement in the outcome(s) of interest after the implementation of the program (i.e. increase in smoking cessation, not just the delivery of a smoking cessation program). The outcome measure(s) is/are compared at relevant time periods before and after the intervention or program implementation. Alternatively, the evaluation study compares the outcome(s) between an intervention group and an appropriate control group.
  3. The study is of peer-review quality and presents numbers in a scientific manner; measurements of precision and reliability are included (e.g. confidence intervals, standard errors), results from statistical tests show a significant difference or change in the outcome measure(s), and relevant point estimates and p-values are presented. Note: if the results from an evaluation of a program are presented in a scientific manner and the outcome measure is improved compared to the baseline measurement or the control group but the difference is not statistically significant, the practice is classified as effective and not evidence-based.