4.6 Article

Evaluation of the Environmental Scoring System in Multiple Child Asthma Intervention Programs in Boston, Massachusetts

Journal

AMERICAN JOURNAL OF PUBLIC HEALTH
Volume 108, Issue 1, Pages 103-111

Publisher

AMER PUBLIC HEALTH ASSOC INC
DOI: 10.2105/AJPH.2017.304125

Keywords

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Funding

  1. US Environmental Protection Agency (EPA) [09-1510801]
  2. US Office of Housing and Urban Development Office of Healthy Homes and Lead Hazard Control Demonstration Program [FR-5300-N-17, MALHH0207-09]
  3. National Asthma Control Initiative, National Asthma Education and Prevention Program of the National Heart, Lung, and Blood Institute, National Institutes of Health (NIH) [4066-06S-BPHC-01]
  4. Centers for Disease Control and Prevention Racial and Ethnic Approaches to Community Health US grant [1U58DP001055]
  5. Health Resources in Action's Health Care Innovation Award [1C1CMS331039]
  6. Healthy Tomorrows Partnership for Children Program [1H17MC21564]
  7. Maternal and Child Health Bureau [T71MC00009]
  8. Health Resources and Services Administration
  9. Ludke
  10. Covidien
  11. Boston Scientific
  12. BJ Foundation
  13. Thoracic Foundation
  14. Boston Children's Hospital's Program for Patient Safety and Quality and Office of Community Health

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Objectives. To test the applicability of the Environmental Scoring System, a quick and simple approach for quantitatively measuring environmental triggers collected during home visits, and to evaluate its contribution to improving asthma outcomes among various child asthma programs. Methods. We pooled and analyzed data from multiple child asthma programs in the Greater Boston Area, Massachusetts, collected in 2011 to 2016, to examine the association of environmental scores (ES) with measures of asthma outcomes and compare the results across programs. Results. Our analysis showed that demographics were important contributors to variability in asthma outcomes and total ES, and largely explained the differences among programs at baseline. Among all programs in general, we found that asthma outcomes were significantly improved and total ES significantly reduced over visits, with the total Asthma Control Test score negatively associated with total ES. Conclusions. Our study demonstrated that the Environmental Scoring System is a useful tool for measuring home asthma triggers and can be applied regardless of program and survey designs, and that demographics of the target population may influence the improvement in asthma outcomes.

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