A Multicomponent, Multi-Trigger Intervention to Enhance Asthma Control in High-Risk African American Children

Mark H. Ebell, MD, MS; Stephanie Patrice Hall, PhD, MPH; R. Chris Rustin, DrPH; Kia Powell-Threets, MS; Luis Munoz; Kia Toodle; (Mary) Lu Meng, PhD; Jean O'Connor, JD, MPH, DrPH


Prev Chronic Dis. 2019;16(5):e69 

In This Article


Of the 135 children screened, 46 were eligible to participate in the intervention. In all, 25 children were recruited for the study, and 23 completed the program, resulting in 23 participants with follow-up data obtained for all children. Of the 23 children, 14 were boys, 21 were African American, and 19 were non-Hispanic. Of 18 participants reporting their income, all had an estimated annual household income less than $30,000, and the head of household was described as the mother for 15 of 23 children. Only 4 households reported that they had smokers, and only 1 reported smoking inside the home.

There were clinically and statistically significant improvements in parental assessments of asthma control, frequency of nighttime awakenings, and activity limitation (Table 1). For example, the number of children whose asthma was assessed as being well controlled went from 4 out of 20 to 17 out of 20 (P < .001) (data were missing for 3 children).

There were significant reductions in days of school missed (1.4 vs 3.3, P = .01) and emergency department visits in the past 6 months (0.27 vs 0.95, P = .004), with similar findings for emergency department visits in the past 12 months (Table 1). There were also fewer parent-reported hospitalizations for asthma in the past 12 months at the 12-month follow-up (0.18 vs 0.59, P = .05).

While the general trends regarding the frequency of daytime and nighttime symptoms was toward improvement in each of the 3 follow-up surveys, this difference was only significant for daytime symptoms at the 1 to 3 months follow-up (Table 2). Use of rescue inhalers decreased and use of controller inhalers increased, although none of these differences was significant because of the small sample size.

The most common action plan items that were recommendations from the healthy homes assessment were cleaning to mitigate dust and dirt (n = 14), getting a mattress or pillow protector (n = 10), and cockroach mitigation (n = 9) (Table 3). Of 69 recommendations, 37 had been fully mitigated and 7 were partially mitigated on the return visit.