Evaluation of a Home-Based Environmental and Educational Intervention to Improve Health in Vulnerable Households: Southeastern Pennsylvania Lead and Healthy Homes Program

Abstract

This evaluation examined whether participation in a home-based environmental educational intervention would reduce exposure to health and safety hazards and asthma-related medical visits. The home intervention program focused on vulnerable, low-income households, where children had asthma, were at risk for lead poisoning, or faced multiple unsafe housing conditions. Home visitors conducted two home visits, two months apart, consisting of an environmental home assessment, Healthy Homes education, and distribution of Healthy Homes supplies. Measured outcomes included changes in participant knowledge and awareness of environmental home-based hazards, rate of children’s asthma-related medical use, and the presence of asthma triggers and safety hazards. Analysis of 2013–2014 baseline and post-intervention program data for a cohort of 150 families revealed a significantly lower three-month rate (p < 0.05) of children’s asthma-related doctor visits and hospital admissions at program completion. In addition, there were significantly reduced reports of the presence of home-based hazards, including basement or roof leaks (p = 0.011), plumbing leaks (p = 0.019), and use of an oven to heat the home (p < 0.001). Participants’ pre- and post- test scores showed significant improvement (p < 0.05) in knowledge and awareness of home hazards. Comprehensive home interventions may effectively reduce environmental home hazards and improve the health of asthmatic children in the short term.

Environmental Justice Research: Contemporary Issues and Emerging Topics

“…Several articles in this Special Issue advance environmental health justice scholarship by documenting linkages between unequal environmental exposure and adverse health impacts associated with unsafe infrastructure and homes [5,14], substance use and addiction [15], and children’s obesity and academic performance [16]. Campbell et al [5] provide a detailed assessment of the recent drinking water crisis and lead poisoning in Flint, USA.…”

“…In addition to describing how this tragedy happened and why socially disadvantaged populations are at particularly high risk for lead exposure, Campbell et al discuss how childhood lead exposure and Flint-like events can be prevented from occurring in the future. Mankikar et al [14] examine whether participation in a two-month long environmental education intervention program reduces exposure to homebased environmental health hazards and asthma-related medical visits. Their home intervention program in southeastern Pennsylvania, USA, focused on low-income households where children had asthma, were at risk for lead poisoning, or faced multiple unsafe housing conditions.…”

“…Promoting and achieving EJ : While EJ scholars often focus on describing the injustices experienced by socially disadvantaged communities, several articles in this Special Issue direct attention toward efforts to achieve EJ through implementation of interventions to improve environmental knowledge and health [14,17], identification of avenues for sustainable and just community and societal change [1,8,9,13], and incorporation of EJ metrics in government programs [12]. In the area of interventions, Ramirez-Andreotta et al [17] examine parental perceptions of the “report back” process after an exposure assessment.…”

“…The findings suggest that providing information to EJ community members could be an effective strategy to reduce exposure, when immediate wider scale remediation is not possible. While Mankikar et al [14] was summarized above, what is relevant here is that low income communities disproportionately face challenges from poor quality housing, especially renters. The promise of the type of intervention conducted by Mankikar et al for achieving EJ is that it works to improve the environmental health of children.…”

From Content Knowledge to Community Change: A Review of Representations of Environmental Health Literacy

“…A subset of studies has demonstrated the value of community health workers and home-visiting professionals in environmental health interventions, and these studies explicitly incorporated self-efficacy into study design. Working with 150 urban families in a northeastern state, Mankikar, Campbell, and Greenberg [ 33 ] analyzed the influence of a home-based environmental health intervention on knowledge of environmental health hazards, presence of hazards in homes, and medical visits for children with asthma. Two home visits were conducted by community health workers and included a home assessment (with pre-/post-assessments), environmental education, and distribution of supplies.…”