Department of Environmental and Public Health Sciences, University of Cincinnati, Cincinnati, OH 45267-0056, USA.
Cincinnati Children's Hospital Medical Center, Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH 45229-3026, USA.
Int J Environ Res Public Health. 2021 Dec 24;19(1):172. doi: 10.3390/ijerph19010172.
Pediatric asthma morbidity is often linked to challenges including poor housing quality, inability to access proper medical care, lack of medications, and poor adherence to medical regimens. Such factors also propagate known disparities, by race and income, in asthma-related outcomes. Multimodal home visits have an established evidence base in support of their use to improve such outcomes. The Collaboration to Lessen Environmental Asthma Risks (CLEAR) is a partnership between the Cincinnati Children's Hospital Medical Center and the local health department which carries out home visits to provide healthy homes education and write orders for remediation should code violations and environmental asthma triggers be identified. To assess the strengths and weaknesses of the program, we obtained qualitative feedback from health professionals and mothers of children recently hospitalized with asthma using key informant interviews. Health professionals viewed the program as a positive support system for families and highlighted the potential benefit of education on home asthma triggers and connecting families with services for home improvements. Mothers report working to correct asthma triggers in the home based on the education they received during the course of their child's recent illness. Some mothers indicated mistrust of the health department staff completing home visits, indicating a further need for research to identify the sources of this mistrust. Overall, the interviews provided insights into successful areas of the program and areas for program improvement.
儿科哮喘发病率常与以下挑战有关，包括住房质量差、无法获得适当的医疗护理、缺乏药物以及对医疗方案的依从性差。这些因素还加剧了与哮喘相关的结果在种族和收入方面的已知差距。多模式家访在改善这些结果方面有其既定的证据基础支持。减少环境哮喘风险合作组织（CLEAR）是辛辛那提儿童医院医疗中心和当地卫生部门之间的合作关系，开展家访以提供健康家庭教育，并在发现法规违规和环境哮喘诱因时开出处方以进行补救。为了评估该计划的优势和劣势，我们通过关键知情人访谈，从最近因哮喘住院的儿童的卫生专业人员和母亲那里获得了定性反馈。卫生专业人员认为该计划是家庭的一个积极支持系统，并强调了有关家庭哮喘诱因教育和将家庭与改善家庭环境的服务联系起来的潜在好处。母亲们表示，根据她们在孩子最近患病期间接受的教育，正在努力纠正家中的哮喘诱因。一些母亲表示对进行家访的卫生部门工作人员不信任，这表明需要进一步研究以确定这种不信任的来源。总的来说，访谈提供了对该计划成功领域和计划改进领域的深入了解。
