1 CLPPP Transitions Course Expanding from a Childhood Lead Poisoning Prevention Program to a Healthy Homes Program

2 Health problems related to housing conditions  Asthma  Allergies  Brain damage  Behavior & learning problems  Lung cancer  Injuries  Poisonings

3 Context for a Healthy Homes Program  Part of Goal 2 of Healthy People 2020 (a national health agenda)  Part of Healthy People 2020 Environmental Health Objectives  Surgeon General’s Call to Action to Promote Healthy Homes  Presidential Executive Order for Environmental Justice  CDC’s Healthy Homes Initiative

4 Conducting a Needs Assessment First step in developing a Healthy Homes Program. The needs assessment should address: — Community analysis — Training and education — Policy — Program experience — Partnerships — Program evaluation — Surveillance Strategic Plan

5 Community Analysis  What are the community demographics?  What are the health issues in the community?  What are the housing needs in the community?

6 Training and Education Healthy Homes Training Center courses:  Essentials for Healthy Homes Practitioners  Launching a Healthy Homes Initiative  Pediatric Environmental Home Assessment (on-line training)  Healthy Homes for Community Health Workers  Integrated Pest Management in Multi-family Housing  Code Inspection for Healthy Homes Go to

7 Training and Education (continued) CDC Healthy Homes/Lead Poisoning Prevention Training Center – 4 tracks:  Program Management  Data Management and Surveillance  Case Management  Primary Prevention

8 Policy Identify strengths and gaps in:  State and local laws  Regulations  Ordinances  Program enforcement policies Identify local housing codes and who enforces them Develop an approach to address gaps

9 Program Experience Assess organizational capacity: Agency resources Past performance Infrastructure Management Knowledge/skills of staff pertaining to Healthy Homes Don’t forget the Healthy Homes Specialist Credential

10 Partnerships Identify partners who can help address healthy homes issues: Housing programs Public health programs Faith-based and community organizations Environmental justice and academic centers Local, state and federal governments Youth centers Universities Fire departments Advocacy groups Others

11 Referral Process Develop plan to identify, address and resolve housing issues. Sample flowchart to describe referral process: Home visiting Pgm./ HH Inspectors Reassess Issue Identify issue Program addresses Partner addresses No Issue Resolved? Yes Document in HH database Permanent

12 Program Evaluation Evaluation should answer two questions: 1.Are program activities being implemented and functioning as planned? (process evaluation) 2.Are program activities having the intended effect? (outcome/impact evaluation) Suggested approaches to evaluation: —Four standards of utility, feasibility, propriety and accuracy —Using SMART objectives (specific, measurable, achievable, relevant and time bound) —Logic model

13 Surveillance May need to modify existing surveillance systems or develop new ones to include healthy homes issues. CDC has developed a new web-based Healthy Housing and Lead Poisoning Surveillance System (HHLPSS) that is available Contact your CDC project officer for more information on how to obtain or transition to HHLPSS

14 Strategic Plan Should address four primary questions:  Who is the target audience for the intervention?  What are the HH constraints of the target audience for the intervention?  How will the identified HH needs/constraints be addressed?  What are the expected outcomes?

15 Best Practices - Programs should focus on interventions with proven efficacy. - Here is a sample of Interventions where there is “sufficient evidence” to indicate efficacy in improving health:  Multi-faceted tailored asthma interventions  Integrated Pest Management (pest/allergen reduction)  Moisture intrusion elimination  Radon air mitigation through active sub slab depressurization  Smoking bans

16 Best Practices (continued) - Programs should focus on interventions with proven efficacy. - Here is a sample of Interventions where there is “sufficient evidence” to indicate efficacy in improving health:  Smoke Detectors  Lead hazard control  Installation of working smoking alarms  Pre-set safe temperature hot water heaters  Housing Choice rental voucher program