Effect of Home Environmental Assessment and Intervention on Pediatric Asthma Management for Native American Children

This study assesses whether identification and remediation of home environmental asthma triggers result in reduced asthma burden for Native American children residing on three Midwestern Indian reservations.

This is a prospective cohort study of children ≤ 17 years of age from three reservations who were enrolled and followed for 12 months after an initial home assessment for asthma triggers. Home environmental issues (maintenance, heating, odor, pests, pets, and smoking) were assessed; family-specific remediation products and educational activities were provided by tribal services. Demographic information (age, sex), information about the child's asthma status, and data related to home conditions and asthma triggers were recorded. Data related to the burden of asthma on children’s lives were collected using the Child Asthma Short Form (CASF) questionnaire at baseline and follow-up. Generalized estimating equation (GEE) was used to determine the effect of addressing home environmental issues on asthma burden.   

The program enrolled 158 Native American children with a mean age 7 years (± 4.5). The mean number of house heating issues was 1.07 (± 1.09); the mean number of house maintenance issues was 2.8 (± 2). At 12 months follow-up, children had significantly higher odds of reduced asthma burden (OR: 2.36, p=0.0035) and fewer functional limitations (OR: 1.76, p=0.0412) using the Child Asthma Short Form. Decreases in asthma burden differed by season (Fall/Summer compared to Winter/Spring). As anticipated, an increase in the number asthma triggers was associated with lower ability to reduce the asthma burden (p=0.040).

Home environmental asthma triggers have a negative impact on children's lives and the ability to optimally manage asthma. Asthma trigger remediation efforts contributed to improved asthma outcomes for the participating Native American children.