Reducing Environmental Triggers of
Asthma in the Home
Kathleen Norlien, Research Scientist
Kelly Raatz, Asthma Program Coordinator
Minnesota Department of Health Asthma Program
Project Goal
To reduce or eliminate home environmental
triggers of asthma for families living in
Section 8 multi-family housing
Objectives of HUD Grant
• Assess the home environment for potential
triggers of asthma
• Provide allergen reducing products: bed/pillow
encasements, HEPA air cleaner, and HEPA
vacuum cleaner
• Provide recommendations to assist child/family
with control of the child’s asthma
• Educate about asthma and importance of selfmanagement skills - including asthma medication
use and asthma action plans
Focus on the bedroom of the child with asthma
Project Background
• Recruit 200 low income children under 18 years of
age with asthma – Section 8 multi-housing
• Diagnosis of asthma
• Five local public health agencies recruit/enroll 40
children in each county or city
• Other key partners:
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•
•
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Respiratory therapist – provided LPH training
American Lung Association of MN – clinician education
Data IQ – data collection & analysis
Wellshare International - community link for project
recruitment
Hospitalizations by Zip Codes
LPH Agencies:
• Anoka County
• Dakota County
• Ramsey County/
St. Paul
• City of Bloomington
• City of Minneapolis
Public Health Nurse Training
1. Classroom training on home visit interviewing skills,
documentation/ field forms, etc.
2. Between 2 and 5 mentoring visits
– Medical management: EPR-3 Guidelines – 4
Components of Asthma Management, Asthma
Control Test (ACT), Asthma Action Plan (AAP),
medication check, correct use of equipment &
storage of that equipment
– Address environmental triggers:
Identification of asthma triggers and methods to
reduce or eliminate those triggers
Timeline
• Enrollment period for 40+ children
February 2012 through July 2013
• Visits:
• Baseline visit
• Product Delivery
• 6 month visit (or telephone follow-up)
• 12 month visit (or telephone follow-up)
• July 2013 - All baseline visits completed
• July 2014 - Data submitted to MDH
• Fall of 2014 - Data analysis/final report to HUD
LPH Recruitment Approaches
•
•
•
•
•
•
•
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Outreach at Cedar Riverside community events
HUD Property Managers – door hangers
Schools/ School Nurses
WIC Clinics
Head Start
Clinician presentations w/PCP
Health Plan – (Medica) mailing
Printed announcements –
– newsletters, flyers, and other focused communications
Preliminary Results - Minneapolis
Asthma Triggers Inside the Home
Common areas:



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
Cooking odors
Smoking
Mustiness, dampness
Urine
Walk off mats, absent or
dirty
Individual residences:
N= 45
 Air fresheners/scented
candles/incense (27%)
 Smoking (20%)
 Pets (18%)
 Mold (29%)
 Pests:
• Cockroaches/bed bugs
(31%)
• Rodents (20%)
Products Provided
Targeted interventions
Bed encasements (84% )
Pillow encasements (84%)
HEPA air cleaner (82%)
HEPA vacuum cleaner (76%)
Swiffer duster & mop (4%)
Other cleaning supplies (4%)
Symptom Burden
33%
35
30
22%
25
20
Baseline
12 months
15
6%
10
5
0%
0
Severe Daytime
Burden
Severe Nighttime
Burden
Functional Limitations
68%
70
60
50
40
26%
30
20
10
0
Minimal Limitations
Baseline
12 months
Asthma Control Test (ACT )
©
43%
50
40
30
14%
20
10
0
In Control
Baseline
12 months
Expected Results (past projects)
• Reductions
– Emergency dept. visits
– Unscheduled office visits
– Hospitalizations
• Improvements
– Fewer daytime and nighttime symptoms
– Fewer missed school/work days
• Return on investment
– RETA $1,960 medical costs saved per child
– CRETA $5.25 savings for every $1 spent
Success Stories
Local Public Health Nurse
Contacts and Credits
Kathleen Norlien
Kathleen.Norlien@state.mn.us
Kelly Raatz
Kelly.Raatz@state.mn.us
Minnesota Department of Health
http://www.health.state.mn.us/asthma/
This project is made possible by the financial support from the US
Housing and Urban Development, Office of Healthy Homes and Lead
Hazard Control Grant (MNAIH0003-11)