Home-Based Asthma Support and Education for Adults (HomeBase)

Public Health - Seattle and King County

Status: Completed

Conditions: Asthma

Treatments: Behavioral: Community Health Worker support

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT01783028

PHSKC-AST-HomeBASE

1R01ES014583-01A1 (U.S. NIH Grant/Contract)

Details and patient eligibility

About

This study tests the hypothesis that community health workers providing home visits to provide education and support for self-management of asthma, assessment of the home for environmental triggers, resources for asthma control, and assistance in effective communication with medical providers over the course of one year would reduce asthma morbidity, asthma-related urgent health care use and exposure to indoor asthma triggers among low income adults with not well controlled asthma.

Full description

We used a randomized controlled parallel group design to compare the intervention to a usual-care control group. We attempted to evaluate the effectiveness of the intervention in the "real world," rather than its ideal efficacy.

The CHWs used protocols that specified education content, participant skill development and participant and CHW actions. The CHWs modified their approach to meet the priorities of participants using motivational interviewing techniques. They addressed asthma patho-physiology, reliever and controller medication use, self-monitoring, use of an asthma action plan, environmental assessment, trigger avoidance, effective use of the health care system, successful communication with health care providers, and weight control (obesity is associated with increased asthma symptoms). Participants also received low-literacy educational materials, in English or Spanish. The education concepts and environmental assessment activities were based on our prior healthy homes work modified for adults.

Enrollment: 366 patients

Sex: All

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• residence of King County Washington
• household income below the 250% of the 2007 federal poverty level
• had "not well controlled asthma" or "very poorly controlled asthma"

Exclusion criteria

• speak a language other than English or Spanish
• no permanent housing

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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366 participants in 2 patient groups

Community Health Worker support

Experimental group

Description:

home visits from community health workers providing education and support for self-management of asthma, assessment of the home for environmental triggers, resources for asthma control, and assistance in effective communication with medical providers

Treatment:

Behavioral: Community Health Worker support

the usual care control group

No Intervention group

Description:

Usual care is defined as services received by participants in the absence of the intervention plus information about community resources that support asthma self-management (such as classes and support groups) and educational pamphlets