Utilizing the Community Health Worker Model to communicate strategies for asthma self-management and self-advocacy among public housing residents

Abstract

Non-Hispanic Black children in the US experience a higher prevalence of asthma and are more likely to have severe and poorly controlled asthma than their non-Hispanic White counterparts. These disparities are particularly pronounced among those living in public housing compared to the general population. To combat these disparities, health care researchers collaborated with public housing management to deliver a year-long community health worker (CHW) asthma and healthy homes intervention to children with asthma in six public housing developments. CHWs, hired from the targeted housing developments, educated families to better manage asthma medically and address asthma triggers in the home, and served as a bridge to medical, social, and public housing services. This is the first time such a full spectrum asthma intervention has been implemented by CHWs in public housing. Fifty-nine children completed the intervention, 95% of whom were African American. Daytime asthma symptoms in the previous two weeks were significantly reduced between baseline (4.1) and 1-year follow-up (0.8). The percent of children making two or more urgent health resource utilization visits decreased significantly between baseline (42%) and 1-year follow-up (15%). Quality of life scores for caregivers of children increased significantly (by 0.7 points). The implementation of the CHW model in a public housing setting not only meets children where they live, but effectively bridges the gap between them and the health care system, reducing the disproportionate burden of asthma in these communities and improving overall quality of life.

Keywords:

• African Americans
• Asthma
• Community health workers
• Health education
• Pediatrics
• Public housing

Additional information

Notes on contributors

Melissa Gutierrez Kapheim

Melissa Gutierrez Kapheim, MS is an epidemiologist and program director at the Sinai Urban Health Institute (SUHI) in Chicago, IL. Melissa is a nationally recognized expert in the implementation of the CHW model and adaption of the model to health care settings. She has led several community-based asthma interventions and directs the implementation of the Sinai Community Health Survey.

Jessica Ramsay

Jessica Ramsay, MPH, AE-C is the Community Health Worker intervention director for the Sinai Asthma Program and a lead CHW training facilitator at SUHI. Since 2011, Jessica has hired, trained and supervised CHWs for three asthma CHW interventions.

Tala Schwindt

Tala Schwindt is an epidemiologist at SUHI and has been evaluating the Sinai Asthma Program’s community-based interventions. Tala received her MPH in Epidemiology from the University of Michigan in 2008.

Bijou R. Hunt

Bijou R. Hunt is an epidemiologist at SUHI. Bijou oversees SUHI’s work with vital records data and has published several papers examining racial disparities in mortality in Chicago, the US, and other large cities across the nation.

Helen Margellos-Anast

Helen Margellos-Anast is a senior epidemiologist at SUHI, where she has been involved in applied asthma and disparities research for over 14 years. Helen is currently the principal investigator of a PCORI funded multi-site asthma comparative effectiveness research study and a HUD funded community health worker-based adult asthma study.