Presentation on theme: "A Community Health Worker Program to Address Indoor Environmental Triggers for Childhood Asthma in East Harlem Public Housing: Implementation and Outcomes."— Presentation transcript:
1 A Community Health Worker Program to Address Indoor Environmental Triggers for Childhood Asthma in East Harlem Public Housing: Implementation and OutcomesRay López1; Anne Bozack, MPH2; Tongtan Chantarat, MPH2; Linda Weiss, PhD21 Environmental Health & Family Asthma Program, LSA Family Health Service2 Center for Evaluation and Applied Research, The New York Academy of Medicine
2 Family Asthma ProgramCommunity Health Worker home visits focus on housing conditions and family habits that may affect a child’s asthmaServices include:Repeated CHW home visits over a 1 year periodCase managementRemediation to improve indoor air quality and eliminate asthma triggersHands-on training for caregiversAllergy control and pest management productsTenant organizing and advocacy
3 CAHR – Controlling Asthma through Home Remediation Expansion of the Family Asthma ProgramFunded HUD’s Office of Healthy Homes and Lead Hazard ControlFamilies living in East Harlem public housing with children 17 and under with severe or persistent asthmaReferrals from health care providers, asthma specialists, and other community organizationsEvaluated by The New York Academy of Medicine
13 Evaluation Overview Evaluation measures Mixed methods utilizing Changes in household conditionChanges in caregiver knowledgeChanges in child’s healthResources for implementationMixed methods utilizingAssessments at baseline, 3, 6, and 12 months:CHW visual assessments of housing conditionsCaregiver surveys of housing conditionsCaregiver surveys of child’s healthCaregiver satisfaction surveys and qualitative interviewsProgram and administrative records
14 Baseline Characteristics Children (N = 152)n(%)Age, Mean (SD)8.34(4.52)GenderFemale74(48.7)Male78(51.3)Race/EthnicityHispanic/LatinoAfrican American52(34.2)Mixed Race16(10.5)Other or unknown10(6.6)Households (N = 98)Number of children enrolled per family164(65.3)222(22.4)34(4.1)8(8.2)Years at address, Mean (SD)10.3(9.25)
18 AdvocacyQuarterly meetings with NYCHA & residents known to LSA to address repairs.Co-chair of NYCAP’s Environment CommitteeTemplate letter for physiciansKnow Your Housing Rights“Breathless” Documentary on Dateline NBC
19 NYCHA v. Baez Settlement Americans with Disability ActDecember 2012: Request for AccommodationJune 2013: Negotiations with NYCHADecember 2013: Reached SettlementApril 2014: Settlement Certified by judgeMay 2014: Implementation begins
20 Discussion Unique program characteristics Implemented by CHWs In-home remediation and trainingThere’s a difference between briefing you and actually sitting you down and showing you what you’re supposed to do…I like the hands-on.AdvocacyI had to go into Housing court and they helped out. I wouldn’t have gotten a lot of things done [without] the letters that [the EHW] wrote to me.
21 Discussion Challenges Difficulty reaching referral targetsReferred families residing in private housing (not eligible)Engaging families and following-up with familiesStructural deficiencies limit environmental improvements: policy changes are critical for program successLimitationsNo control groupEffects of NYCHA settlement not knownSustainabilityNeed for CHW services to be reimbursable
22 Contact InformationRay López, DirectorEnvironmental Health & Family Asthma ProgramLittle Sisters of the Assumption Family Health Service(646)Anne Bozack, MPH, Project DirectorCenter for Evaluation and Applied ResearchNew York Academy of Medicine
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