Asthma Health Outcomes Project
Overviews of Surveyed Asthma ProgramsSeptember 2005
Domestic Programs: Michigan (cont'd)
Community Action Against Asthma (CAAA)
University of Michigan School of Public Health
Edith A. Parker, DrPH
Community Action Against Asthma (CAAA) was implemented in Detroit, MI from 1999 to 2003 and was managed by the University of Michigan School of Public Health. CAAA was a community-based participatory research (CBPR) community health worker (CHW) intervention designed to improve children's asthma-related health by reducing household environmental triggers for asthma. 328 households in Detroit with a child aged 7-11 with persistent asthma symptoms were randomized to an intervention or a control group.
The intervention consisted of a planned minimum of 9 household visits over a one-year period by community health workers called Community Environmental Specialist (CESs). The initial home visit included general information on asthma and the role of environmental triggers. Subsequent visits were organized into separate modules on the remediation of specific triggers. Based on information gathered during the baseline interview, skin testing, and analysis of bedroom dust, the CESs and caregivers together refined a prioritized list of environmental triggers to focus on. The overall aim was to facilitate the family in making environmental changes in the home to reduce the child's exposure to common asthma triggers.
The intervention was effective in increasing lung function (daily nadir Forced Expiratory Volume at one second and daily nadir Peak Flow); reducing the frequency of two symptoms (cough that won’t go away, coughing with exercise); reducing the proportion of children requiring unscheduled medical visits and reporting inadequate use of asthma controller medication; reducing caregiver report of depressive symptoms; reducing concentrations of cat and dog allergen in the dust; and increasing some behaviors related to reducing indoor environmental triggers. The results suggest a CHW environmental intervention can improve children’s asthma-related health although the pathway for improvement is complex.
Page 88 of 223