Effects of the home-based educational intervention on health outcomes among primarily Hispanic children with asthma: a quasi-experimental study

Abstract

Background Childhood asthma is a significant health issue with 8.3% prevalence in the U.S. Its prevalence is particularly higher among low-income communities in the Texas-Mexico border region, as they often lack access to clinical care and health insurance. This study examines the impact of a home-based education led by Community Health Workers (CHWs) on health outcomes for asthmatic, predominantly Hispanic children in these communities. Methods The study was a quasi-experimental design to learn the effectiveness of the asthma home-based education by comparing changes of health outcomes between baseline and follow-up of intervention and control groups. This study enrolled 290 participants, consisting of 130 in the intervention group and 160 in the control group. The educational intervention led by the CHWs referenced the Asthma and Healthy Homes curriculum and contents of the Seven Principles of Healthy Homes. The multiple linear regression analysis was conducted to estimate the associations between the intervention and each health outcome. Results When comparing the intervention group with the control group, the intervention group showed a significantly greater decrease in asthma attacks than the control group ( p = 0.049). Although all of the five Children’s Health Survey for Asthma (CHSA) scores showed significant improvements between baseline and follow-up in both groups, we found that increases of CHSA scores in the intervention group were higher than the control group except for emotional health of children (EC) score. The multiple linear regression models demonstrated that the mean changes in asthma attacks ( p = 0.036) and emotional health of families (EF) score ( p = 0.038) were significantly better in the intervention group than the control group, adjusting for children’s age of diagnosis, household income, use of steroids, family history of allergy, and type of insurance. Conclusions This study concluded that the home-based education by CHWs effectively improve health outcomes among children in communities lacking access to medical resources. The findings suggest the importance of the home-based education program in promoting emotional and medical care for children and their families in low-income communities like those in the Texas-Mexico border region.

Assessing Impact of Household Intervention on Indoor Air Quality and Health of Children with Asthma in the US-Mexico Border: A Pilot Study

“…Previous studies have shown that families educated with a curriculum based on Asthma and Healthy Homes had improved asthma symptoms and increased knowledge of children and their parents as well as the quality of life for the family [ 14 , 15 , 28 ]. The curriculum is focused on a holistic educational intervention including the signs and symptoms of asthma, the disease management, common triggers of asthma, adequate use of asthma medications, emergency action plans like an asthma attack, and components of an asthma action plan [ 15 ].…”

“…Previous studies revealed that various home-based interventions, including home-based education, home environments evaluation, integrated pest management to control cockroach, and combined interventions to eliminate moisture intrusion and leaks, were effective in improving asthma conditions [13]. Particularly, a recent study presented the home-based education led by the community health workers (CHWs) improved health outcomes of children with asthma and their families in disadvantaged communities [14,15].…”

Effect of Ambient Air Pollution on Hospital Readmissions among the Pediatric Asthma Patient Population in South Texas: A Case-Crossover Study

“…Finally, children's hospitals will be able to collaborate with asthma education/prevention programs in the community to follow up with pediatric patients with asthma more effectively, given a study's argument that optimal inpatient asthma care includes an effective transition to the community with constant follow-up care to prevent repeated hospitalization [42]. Home-visit asthma education has especially been proven to be effective in improving asthma-related health outcomes for the population living in disadvantaged communities with limited access to health care and education [44][45][46]. The community-hospital partnership for education and follow up for pediatric patients with asthma may play a significant role in reducing preventable hospital readmission [47].…”

Association between Ambient Air Pollution and Hospital Length of Stay among Children with Asthma in South Texas

“…Furthermore, age, gender, ethnicity, type of insurance, season, and admission day have been identified as significant factors that affect LOS for patients with asthma in previous literature [5][6][7]28]. Other factors associated with asthma control or exacerbation, including family history of asthma, use of medication, asthma education, and outdoor temperature, also may affect the relationship between outdoor air pollution and LOS [29][30][31][32]. Accordingly, potential confounders were included in the regression models as follows: age when admitted to the hospital (5-11 years old or 12-18 years old), gender (male or female), ethnicity (Hispanic or non-Hispanic), type of insurance (public via U.S. Medicaid, private, or self-pay), family history of asthma or other respiratory disease (yes or no), use of medication (yes or no), experience of asthma education (yes or no), season (warm defined as May to October or cold defined as November to April), admission day (weekday as Monday to Thursday or weekend as Friday to Sunday), and outdoor temperature (moving averages as noted above, in Celsius).…”