1. Healthy Homes for All: Improving Children’s Health in Diverse Communities David Turcotte, ScD; Joann Vaillette; Emily Vidrine; Susan Woskie, Ph.D.; Rebecca Gore; Fred Youngs; University of Massachusetts Lowell Carla Caraballo & Bophamony Vong; Lowell Community Health Center

2. Funded by the U.S. Department of Housing and Urban Development Why asthma? Why Lowell? –High asthma rate –Diverse community –Community health partners

3. Project Goals: Families First time home buyers Home assessmentsEducation Home interventions Education Partners Education

4. Partners & Roles University of Massachusetts Lowell Lowell Community Health Center Coalition for a Better Acre Community Teamwork Inc. Lowell Housing Authority Merrimack Valley Housing Partnership

5. Families – who are they? Live in Lowell Have at least one child with asthma (<=14) Low-moderate income 165 families enrolled (245 children)

6. What is Asthma? A serious & sometimes life-threatening respiratory disease Affects the quality of life for millions of Americans No cure for Asthma yet Can be controlled through medical treatment & management of environmental triggers

7. Americans spend up to 90% of their time indoors Indoor concentrations of most pollutants are higher than outdoor Indoor Environment and Asthma

8. Indoor allergens and irritants can play significant roles in triggering asthma attacks –Ex: pet dander, mice, cockroaches, dust mites, harsh chemicals, fragrances, smoke, moisture/mold, pollen Important to recognize potential asthma triggers & reduce exposure

9. Home Intervention - Assessment Health/environmental assessments –Health questionnaire with parent –Environmental walk-through assessment –Environmental questionnaire with parent –Dust sampling Assessment Education, Supplies, Remediation Mid-term Assessment 6 th month Final Assessment 12 th month

10. Education, Supplies, Remediation Education –Dust mites and healthy cleaning practices –Pets –Avoiding pests –Moisture/mold control –Smoking –Air pollution (indoor & outdoor) –Safety Supplies –HEPA vacuum –Allergen-proof mattress and pillow covers –Trash can with lid –Food containers –Non-toxic cleaner –Baits and traps for pests –Safety items Assessment Education, Supplies, Remediation Mid-term Assessment 6 th month Final Assessment 12 th month Based on findings from assessment:

11. Education, Supplies, Remediation Cont. Remediation –Carpet removal –Install ventilation –Integrated Pest Management (IPM) –Industrial cleaning Assessment Education, Supplies, Remediation Mid-term Assessment 6 th month Final Assessment 12 th month

12. Mid-term Assessment Health questionnaire (abbreviated) Environmental questionnaire (abbreviated) More supplies if needed Reinforce education Assessment Education, Supplies, Remediation Mid-term Assessment 6 th month Final Assessment 12 th month

13. Final Assessment Health questionnaire Environmental questionnaire Environmental walk-through Gift certificate Assessment Education, Supplies, Remediation Mid-term Assessment 6 th month Final Assessment 12 th month

14. Accomplishments Conducted 178 home assessments Completed 160 interventions Evaluation of intervention effectiveness (midterms & final assessments) Trained 75 partner staff in HH practices Provided HH education to 1,537 community members

15. Results Asthma Indicators

16. Results Cont. Change in CHSA Scores Attribute Baseline Mean Final Mean Change (paired values) Physical Health 66.889.323.3 Activity Child 84.993.08.4 Activity Family 88.797.48.7 Emotional Health Child 67.988.020.5 Emotional Health Family 71.281.19.9 n=170

17. Results Cont. Reduced use of asthma medication (Reported use in prior 4 weeks) Baseline –145 of 164 using meds (88%) Final –101 of 164 using meds (62%)

18. Lessons Learned Start early & stay on schedule One-on-one outreach a must Importance of ongoing outreach Expect delays Don’t reinvent the wheel Tracking system is a must Regular communication is key

19. Lessons Learned Cont. Don’t schedule initial appointments too far in advance Importance of building trust with families Need to reinforce HH education Provide value on all home visits Respect diverse cultures/practices

20. Contact Information David Turcotte, Sc.D. University of Massachusetts Lowell Email: David_Turcotte@uml.eduDavid_Turcotte@uml.edu Telephone: (978) 934-4682 Emily Vidrine, M.A. University of Massachusetts Lowell Email: Emily_Vidrine@uml.eduEmily_Vidrine@uml.edu Telephone: (978) 934-4778