A Home Environment Intervention Program for Children with Asthma: The Minnesota Model

Background: Health care providers have not been able to address issues in the home environment affecting asthma control. Objective: To assess the impact of a home assessment and modification program for children with asthma on health service utilization, school absenteeism and health related quality of life. Methods: Children with uncontrolled mild persistent, moderate persistent or severe asthma were referred. An Environmental Asthma Action Plan was written for each home; allergen reducing products were provided; minor repairs and structural modifications were completed if needed. Care management was coordinated with providers; referrals to other government programs were made for qualified families. Number of hospitalizations, emergency room admissions, oral corticosteroid use and school absences due to asthma were collected and a health related quality of life instrument completed for each child at baseline. Follow-up data was collected by phone at 3, 9 and 12 months and during a home visit at 6 months. Results: 421 children received services. Smoking, dust mites, ventilation and pets were common concerns. Average program costs ranged from $468 (products only) to $1068 (products and structural modifications) per home. Hospitalizations, school absences and symptom burden showed statistically significant reductions from baseline (p <0.05). Program costs were offset by savings from reductions in hospitalizations with added benefits of improved school attendance and decreased symptom burden. Conclusion: A home environmental modification program focused on environmental concerns contributing to asthma has a positive influence. The program has filled unmet needs with a service previously lacking in asthma care.