Section of Environmental Epidemiology & Toxicology, Louisiana Department of Health, New Orleans, LA, USA.
Immunization Program, Louisiana Department of Health, New Orleans, LA, USA.
Public Health Rep. 2024 Jul-Aug;139(1_suppl):53S-61S. doi: 10.1177/00333549241236090. Epub 2024 Mar 21.
The Louisiana Department of Health identified a need for greater outreach in low-income Black communities that addressed environmental asthma triggers. We piloted an asthma virtual home visit (VHV) program and evaluated its reach and ability to promote asthma self-management strategies in communities with a high prevalence of poorly controlled asthma.
Participants from Louisiana were continuously recruited into the VHV program starting in March 2021 and provided with asthma education materials. Participants reporting poorly controlled asthma and environmental triggers were also offered 3 VHVs with a respiratory therapist. All participants were asked to complete a preintervention and postintervention knowledge test, an Asthma Control Test (ACT) (maximum score = 25; scores ≤19 indicate poorly controlled asthma), and a final survey that assessed perceptions about asthma management and reduction of environmental triggers.
As of October 2022, 147 participants were enrolled in the program, and 52 had consented to and received ≥1 VHV. Forty VHV recipients (77%) were aged <18 years, 40 (77%) were Black people, and 46 (88%) were from families with extremely low or low incomes. Asthma symptoms improved across all participants, with a median increase of 2.4 points on the ACT. Knowledge tests revealed that 86% of participants learned about ≥1 new asthma trigger; a larger percentage of VHV recipients than nonrecipients (68% vs 36%) had an improved knowledge test score postintervention. Compared with preintervention, about three-quarters of participants reported feeling more empowered to self-manage their asthma and a significant improvement in their quality of life postintervention.
The program provided virtual asthma education to communities with a high burden of asthma and improved asthma outcomes for participants. Similar virtual models can be used to promote health equity, especially in areas with limited access to health care.
路易斯安那州卫生部门发现，需要在收入较低的黑人社区加大宣传力度，解决环境引发哮喘的问题。我们试点了一个哮喘虚拟家访（VHV）项目，并评估了该项目在哮喘控制不佳发病率较高的社区推广哮喘自我管理策略的效果。
从 2021 年 3 月开始，路易斯安那州的参与者不断被招募到 VHV 项目中，并提供哮喘教育材料。报告哮喘控制不佳和环境诱因的参与者还可以获得呼吸治疗师提供的 3 次 VHV。所有参与者都被要求在干预前和干预后完成知识测试、哮喘控制测试（ACT）（最高得分为 25；得分≤19 表明哮喘控制不佳），以及最后一项评估哮喘管理和减少环境诱因的看法的调查。
截至 2022 年 10 月，已有 147 名参与者参加了该项目，其中 52 人同意并接受了至少 1 次 VHV。40 名 VHV 接受者（77%）年龄<18 岁，40 名（77%）是黑人，46 名（88%）来自收入极低或低收入家庭。所有参与者的哮喘症状均有所改善，ACT 中位数增加了 2.4 分。知识测试显示，86%的参与者了解了至少 1 种新的哮喘诱因；与未接受者（36%）相比，接受者（68%）的知识测试得分在干预后有所提高。与干预前相比，约四分之三的参与者表示对自我管理哮喘更有信心，并且生活质量在干预后显著改善。
该项目为哮喘负担沉重的社区提供了虚拟哮喘教育，并改善了参与者的哮喘结局。类似的虚拟模式可用于促进健康公平，尤其是在医疗保健服务有限的地区。
