Inner-City Asthma Study

Inner-City Asthma Study

OVERVIEW

The Inner-City Asthma Study is a randomized trial for children with asthma that educates and demonstrates how to reduce environmental allergen exposure. An evaluation of the study showed a reduction in unscheduled clinic visits and inhaler use, but there was no impact on scheduled medical visits, emergency department visits, hospital admissions, length of hospital stay, or use of anti-inflammatory medications.

DESCRIPTION OF PROGRAM

Target Population: Children age 6-11 with moderate to severe asthma

Over the course of approximately five home visits in 12 months, environmental counselors lead six modules educating and demonstrating how to reduce exposure to dust mites, smoking, cockroaches, pets, rodents, and mold. Each module is customized to the child’s environmental risk and skin test sensitivity. Environmental counselors are high school graduates from the local community. Along with the home visits, families also receive an impermeable mattress and pillow covers. Families with children exposed to environmental tobacco smoke receive a high-efficiency particulate air filter.

In 2001 dollars, the intervention is estimated to cost $1,469 per family. Cost effectiveness results were mixed. The intervention was found to be cost-effective for children with more frequent symptoms, but not for children with more unscheduled clinic visits or hospitalizations..

EVALUATIONS OF PROGRAM

Kattan, M., Stearns, S. C., Crain, E. F., Stout, J. W., Gergen, P. J., Evans, R., Visness, C. M., Gruchalla, R. S., Morgan, W. J., OConnor, G. T., Mastin, J. P., & Mitchell, H. E. (2005). Cost-effectiveness of a home-based environmental intervention for inner-city children with asthma. Journal of Allergy and Clinical Immunology, 116, 1058-1063.

Evaluated Population: Nine-hundred and thirty-seven children aged 5 to 11 years with moderate-to-severe asthma from seven urban locations in the United States participated in this study.

Approach: Children residing in one home for at least five nights per week with at least one hospitalization or two unscheduled asthma visits to a hospital were eligible for the study. Children were randomly assigned to receive the intervention or be placed in a no-treatment control group. At two years, children were assessed on clinic visits, emergency department visits, hospital admissions, length of hospital stay, and pharmaceutical use.

Results: Relative to control group children, intervention group children were 19 percent less likely to make unscheduled clinic visits and 14 percent less likely to use beta-agonist inhalers. There were no impacts on scheduled medical visits, emergency department visits, hospital admissions, length of hospital stay, or use of anti-inflammatory medications.

SOURCES FOR MORE INFORMATION

Inner City Asthma Study Homepage:

http://www.icasweb.org/

References:

KEYWORDS: Children, Males and Females, Urban, Home-based, Parent/Family Component, Cost information is available, Health Status/Conditions, Other Physical health.

Program information last updated on 11/8/10.

		© Child Trends 2004