The Clean Air for Kids (CAFKs) partnership in Tacoma-Pierce County, Washington, implemented a community-based asthma outreach worker (AOW) program focusing on educating caregivers of children with asthma about environmental triggers in the household and asthma management. High rates of health care utilization as well as increased morbidity from asthma are associated with an inadequate understanding of asthma among caregivers of children with asthma. Moreover, the removal of environmental triggers of asthma present in the household has been shown to decrease asthma exacerbations. Managing childhood asthma is of great public health importance due to the overall burden of disease, 8.9 million children under 17 were living with an asthma diagnosis as of 2005, and because of the high level of health care costs associated with the disease.

The AOW contacted interested families and arranged home visits. Using a flexible approach, the AOW assessed the family’s understanding of asthma management and self-management tools were discussed. The AOW visits were followed up with either e-mail or telephone contact. To assist families in reducing environmental triggers of asthma, the American Lung Association of Washington Master Home Environmentalist program was implemented in participating households. This program utilized trained volunteers to assess the homes of children with asthma. The volunteers identified and assisted program participants in developing and implementing an action plan to improve the home environment. For example, families were encouraged to begin using allergen proof pillows, mattress covers and doormats to reduce allergens and to increase ventilation in their residence. Specific cleaning practices that reduce environmental triggers were also demonstrated and discussed.

To increase utilization of asthma management plans and improve quality of life while reducing environmental triggers of asthma in the household and hospitalizations due to asthma among children.

Short-term community-based asthma outreach workers for children can be effective in enhancing self-management capabilities, improving the quality of life, increasing the use of asthma management plans, and helping families reduce asthma triggers at home.

A pre- and post-intervention design was used to evaluate the effectiveness of the AOW program. Caregivers reported significantly higher quality of life for children with asthma at the follow-up evaluation conducted one month after participating in the program. At follow-up evaluation, 93% of the children had asthma management plans as compared with 31% at baseline. Self-reported hospitalizations were significantly reduced. All participating families made changes to minimize household asthma triggers.

The Clean Air for Kids program has grown over the years. Their number of asthma outreach workers has grown, and now includes one funded by the MultiCare Mary Bridge Children’s Hospital & Health Center who is able to access medical records. In addition, Clean Air for Kids is now a key member of the Puget Sound Asthma Coalition.