POPULATIONS AT RISK ACROSS THE LIFESPAN:PROGRAM EVALUATIONS The Impact of an Urban Home-Based Intervention Program on Asthma Outcomes in Children Laura L. Sweet, M.S.N., R.N., 1 Barbara J. Polivka, Ph.D., R.N., 2 Rosemary V. Chaudry, Ph.D., M.P.H., P.H.C.N.S.-B.C., 3 and Philip Bouton, B.A. 1 1 Columbus Public Health, Healthy Homes Program, Columbus, Ohio; 2 School of Nursing, University of Louisville, Louisville, Kentucky; and 3 Delaware General Health District, Delaware, Ohio Correspondence to: Laura Sweet, Columbus Public Health, 240 Parsons Ave., Columbus, OH 43215. E-mail: llsweet@columbus.gov ABSTRACT Objectives: This program evaluation examines the outcomes of a multicomponent urban home-based asthma program implemented through a city health department in a large Midwestern city. The purpose of the program was to improve asthma outcomes by controlling indoor asthma triggers in the home environment. Design and Sample: This was a pre-post evaluation study. Participants received home-based education from a public health nurse or a health educa- tor, cleaning and other supplies, and physical home interventions such as mold abatement and pest control. Asthma outcomes, caregiver quality of life, trigger-related activities, and asthma manage- ment activities at baseline and 6 months following the intervention were evaluated using survey data. A total of 115 participants for whom baseline and follow-up data were available were included in this analysis. Measures: This study used parent self-reported quantitative and qualita- tive data which were collected through baseline and follow-up surveys administered by program staff. Results: Significant reduction in asthma symptom days, nighttime awakenings, days with activ- ity limitation, and albuterol use were observed. Emergency department visits, missed school days, and caregiver missed work days also were significantly reduced, and caregiver quality of life improved. Conclusions: This multifaceted home-based intervention decreased asthma triggers and improved asthma outcomes in children, and improved the quality of life of their caregivers. Key words: asthma, environmental health, program evaluation, urban health. Background Asthma—the most common chronic childhood dis- ease—affects approximately 7.1 million children in the United States. Childhood asthma contributes to missed school days and reduced quality of life (QOL) (Akinbami, Moorman, & Liu, 2011). The burden of childhood asthma falls disproportionately on children in low-income households and children who are African American (Bloom, Cohen, & Free- man, 2010). In 2009, 14% of children in low- income households had asthma, compared with 8% of children in middle or upper income households. Furthermore, 17% of African American children had asthma compared with 8% of White and Hispanic children. Causes of increased prevalence of asthma in low income, urban dwelling, and African Ameri- can populations remain unclear (Gern, 2010). Factors that may be associated with asthma dis- parities include poor nutrition, maternal stress, exposure to pollution, and adverse homes envi- ronmental conditions (e.g., indoor dampness, inadequate ventilation, and pest infestation). In addition to exacerbating asthma symptoms, certain indoor aeroallergens and pollutants—including ciga- rette smoke, dust mite allergen, and mold—increase 243 Public Health Nursing Vol. 31 No. 3, pp. 243–252 0737-1209/© 2013 Wiley Periodicals, Inc. doi: 10.1111/phn.12071