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James W. Krieger, MD, MPH, Tim K. Takaro, MD, MPH, MS, Lin Song, PhD and Marcia Weaver, PhD

James W. Krieger is with Public Health–Seattle & King County and the University of Washington School of Medicine and School of Public Health and Community Medicine, Seattle. Tim K. Takaro is with the University of Washington School of Medicine, Seattle. Lin Song is with Public Health–Seattle and King County. Marcia Weaver is with the University of Washington School of Public Health and Community Medicine, Seattle.

Correspondence: Requests for reprints should be sent to James Krieger, Public Heath–Seattle & King County, 999 Third Avenue, Suite 1200, Seattle, WA 98104 (e-mail: james.krieger{at}metrokc.gov).

Objectives. We assessed the effectiveness of a community health worker intervention focused on reducing exposure to indoor asthma triggers.

Methods. We conducted a randomized controlled trial with 1-year follow-up among 274 low-income households containing a child aged 4–12 years who had asthma. Community health workers provided in-home environmental assessments, education, support for behavior change, and resources. Participants were assigned to either a high-intensity group receiving 7 visits and a full set of resources or a low-intensity group receiving a single visit and limited resources.

Results. The high-intensity group improved significantly more than the low-intensity group in its pediatric asthma caregiver quality-of-life score (P=.005) and asthma-related urgent health services use (P=.026). Asthma symptom days declined more in the high-intensity group, although the across-group difference did not reach statistical significance (P= .138). Participant actions to reduce triggers generally increased in the high-intensity group. The projected 4-year net savings per participant among the high-intensity group relative to the low-intensity group were $189–$721.

Conclusions. Community health workers reduced asthma symptom days and urgent health services use while improving caregiver quality-of-life score. Improvement was greater with a higher-intensity intervention.

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