Seattle-King County Healthy Homes Project

The Seattle–King County (SKC) Healthy Homes Project aimed to reduce asthma morbidity and asthma-triggered health care use and improve asthma-related quality of life by increasing asthma self-management skills and reducing exposure to indoor asthma triggers. The program, which targeted low-income households of children with persistent asthma, used two service delivery approaches: a high-intensity and a low-intensity model. The high-intensity model included an initial home visit by a community asthma nurse who provided patient education, training in self-management, the development of a patient-specific asthma action plan, and case management and review. Families then received up to six follow-up visits from a community health worker (CHW). CHWs provided in-home support, education, indoor trigger identification, and resources (including bedding covers, vacuums, and cleaning supplies) to address environmental triggers. Support for self-management, medication use, and communication with health care providers also were reinforced. The CHWs were educated and trained on asthma, asthma self-management, and the control of environmental asthma triggers. The low-intensity model included the initial home visit only.