TY  - JOUR
T1  - A randomized controlled trial of asthma self-management support comparing clinic-based nurses and in-home community health workers: The seattle–king county healthy homes ii project
AU  - Krieger J, Takaro TK, Song L, Beaudet N, Edwards K
Y1  - 2009/02/02
N1  - 10.1001/archpediatrics.2008.532
JO  - Archives of Pediatrics & Adolescent Medicine
SP  - 141
EP  - 149
VL  - 163
IS  - 2
N2  - Objective 
    To compare the marginal benefit of in-home asthma self-management support provided by community health workers (CHWs) with standard asthma education from clinic-based nurses.Design 
    Randomized controlled trial.Setting 
    Community and public health clinics and homes.Participants 
    Three hundred nine children aged 3 to 13 years with asthma living in low-income households.Interventions 
    All participants received nurse-provided asthma education and referrals to community resources. Some participants also received CHW-provided home environmental assessments, asthma education, social support, and asthma-control resources.Outcome Measures 
    Asthma symptom–free days, Pediatric Asthma Caretaker Quality of Life Scale score, and use of urgent health services.Results 
    Both groups showed significant increases in caretaker quality of life (nurse-only group: 0.4 points; 95% confidence interval [CI], 0.3-0.6; nurse + CHW group: 0.6 points; 95% CI, 0.4-0.8) and number of symptom-free days (nurse only: 1.3 days; 95% CI, 0.5-2.1; nurse + CHW: 1.9 days; 95% CI, 1.1-2.8), and absolute decreases in the proportion of children who used urgent health services in the prior 3 months (nurse only: 17.6%; 95% CI, 8.1%-27.2%; nurse + CHW: 23.1%; 95% CI, 13.6%-32.6%). Quality of life improved by 0.22 more points in the nurse + CHW group (95% CI, 0.00-0.44; P = .049). The number of symptom-free days increased by 0.94 days per 2 weeks (95% CI, 0.02-1.86; P = .046), or 24.4 days per year, in the nurse + CHW group. While use of urgent health services decreased more in the nurse + CHW group, the difference between groups was not significant.Conclusion 
    The addition of CHW home visits to clinic-based asthma education yielded a clinically important increase in symptom-free days and a modest improvement in caretaker quality of life.
SN  - 1072-4710
M3  - doi: 10.1001/archpediatrics.2008.532
UR  - http://dx.doi.org/10.1001/archpediatrics.2008.532
ER  -