CLPPP Transitions Course
Expanding from a Childhood Lead
Poisoning Prevention Program to a
Healthy Homes Program
“The connection
between health and
the dwelling of the
population is one of
the most important
that exists”. [1]
Florence Nightingale
Citado en Lowry, S. BMJ, 1991, 303, 838-840
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Health problems related to housing
conditions
Asthma
 Allergies
 Brain damage
 Behavior &
learning problems
 Lung cancer
 Injuries
 Poisonings

2
Context for a Healthy Homes Program

Part of Goal 2 of Healthy People 2020 (a national
health agenda)

Part of Healthy People 2020 Environmental Health
Objectives

Surgeon General’s Call to Action to Promote
Healthy Homes

Presidential Executive Order 12898 for
Environmental Justice

CDC’s Healthy Homes Initiative
3
Conducting a Needs Assessment
First step in developing a Healthy Homes Program. The needs
assessment should address:
—
Community analysis
—
Training and education
—
Policy
—
Program experience
—
Partnerships
—
Program evaluation
—
Surveillance
Strategic
Plan
4
Community Analysis

What are the community demographics?

What are the health issues in the
community?

What are the housing needs in the
community?
5
Training and Education
Healthy Homes Training Center courses:
 Essentials for Healthy Homes Practitioners
 Launching a Healthy Homes Initiative
 Pediatric Environmental Home Assessment (on-line
training)
 Healthy Homes for Community Health Workers
 Integrated Pest Management in Multi-family Housing
 Code Inspection for Healthy Homes
Go to www.healthyhomestraining.org
6
Training and Education (continued)
CDC Healthy Homes/Lead Poisoning
Prevention Training Center – 4 tracks:
 Program Management
 Data Management and Surveillance
 Case Management
 Primary Prevention
7
Policy
Identify strengths and gaps in:
 State and local laws
 Regulations
 Ordinances
 Program enforcement policies
Identify local housing codes and who enforces
them
Develop an approach to address gaps
8
Program Experience
Assess organizational capacity:
• Agency resources
• Past performance
• Infrastructure
• Management
• Knowledge/skills of staff pertaining to Healthy
Homes
Don’t forget the Healthy Homes Specialist
Credential
9
Partnerships
Identify partners who can help address healthy homes
issues:
• Housing programs
• Public health programs
• Faith-based and community organizations
• Environmental justice and academic centers
• Local, state and federal governments
• Youth centers
• Universities
• Fire departments
• Advocacy groups
• Others
10
Referral Process
Develop plan to identify, address and resolve housing
issues. Sample flowchart to describe referral process:
Home visiting Pgm./
HH Inspectors
Reassess
Issue
Identify issue
Program
addresses
No
Partner
addresses
Issue
Resolved?
Yes
Document in
HH database
Permanent
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Program Evaluation
Evaluation should answer two questions:
1. Are program activities being implemented and
functioning as planned? (process evaluation)
2. Are program activities having the intended effect?
(outcome/impact evaluation)
Suggested approaches to evaluation:
— Four standards of utility, feasibility, propriety and
accuracy
— Using SMART objectives (specific, measurable,
achievable, relevant and time bound)
— Logic model
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Surveillance
May need to modify existing surveillance systems or
develop new ones to include healthy homes issues.
CDC has developed a new web-based Healthy Housing
and Lead Poisoning Surveillance System (HHLPSS) that
is available
Contact your CDC project officer for more information on
how to obtain or transition to HHLPSS
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Strategic Plan
Should address four primary questions:
 Who is the target audience for the
intervention?
 What are the HH constraints of the target
audience for the intervention?
 How will the identified HH needs/constraints
be addressed?
 What are the expected outcomes?
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Best Practices
- Programs should focus on interventions with proven
efficacy.
- Here is a sample of Interventions where there is “sufficient
evidence” to indicate efficacy in improving health:





Multi-faceted tailored asthma interventions
Integrated Pest Management (pest/allergen reduction)
Moisture intrusion elimination
Radon air mitigation through active sub slab
depressurization
Smoking bans
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Best Practices (continued)
- Programs should focus on interventions with proven
efficacy.
- Here is a sample of Interventions where there is “sufficient
evidence” to indicate efficacy in improving health:





Smoke Detectors
Lead hazard control
Installation of working smoking alarms
Pre-set safe temperature hot water heaters
Housing Choice rental voucher program
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