In its Guide to Community Preventive
Services,26 the US Centers for Disease Control
and Prevention (CDC) summarized studies27---35
showing that home visits, in particular those
performed by community health workers
(CHWs) and addressing multiple asthma triggers,
improve self-management behaviors,
reduce exposure to triggers, decrease symptoms
and urgent health care use, and increase
quality of life. The US Department of Housing
and Urban Development (HUD),36 US Environmental
Protection Agency,37 and CDC26
recommend home visits, and the National
Asthma Education and Prevention Program38
recommends that home visits be considered,
but notes that this area needs more research.
The historical Seattle---King County Healthy
Homes II (HH-II) project studied the effectiveness
of CHW home visits for controlling
asthma.39 CHWs provided in-home education
and helped participants implement action plans
that addressed multiple triggers. The study
found that the CHW home education program
was relatively inexpensive, significantly reduced
asthma morbidity and trigger exposure,
and improved caregivers’ quality of life. The
HH-II study also found that adding CHW home
visits to clinic-based asthma education yielded
a clinically important increase in asthmasymptom-free
days and modestly improved
caretakers’ quality of life.39 However, the
homes of many low-income asthmatic children
needed structural interventions beyond the
scope of the home visit program.