Parent experiences with a nurse-supervised community health worker asthma home-visiting program

J Asthma. 2019 Dec;56(12):1314-1324. doi: 10.1080/02770903.2018.1536144. Epub 2018 Nov 5.

Abstract

Objective: This study seeks to identify helpful components of a nurse-supervised Community Health Worker (CHW) asthma home-visiting program, obtain feedback from parents and families about their experiences, and receive suggestions for new services that the program could provide. Methods: Likert scale ratings and semi-structured qualitative interviews were conducted with parents who were selected from a representative sample and previously participated in the program. Five-point Likert scale ratings from 1 (not helpful) to 5 (very helpful) were obtained for 11 program components. Interviews were analyzed using a grounded theory participatory approach. Data were analyzed and themes were identified by two different coders using Dedoose software. Results: A total of 22 participants were enrolled and 20 participants completed Likert scale ratings and qualitative interviews. Likert scale ratings (mean standard deviation [SD]) show that program strengths include asthma education (4.75 [0.55]), supplies (4.65 [0.99]), help with housing conditions (3.94 [1.56], pest management (3.79 [1.69]) and greater access to community resources (3.70 [1.30]). The ratings suggest that families need more help with other social determinants of health, such as school, lack of enough money or food, and mental health and behavioral concerns (3.05 [1.78]). Interviews echoed these ratings and revealed several themes about family and parental stress, children's activity limitations, desire for outreach after the 12-month intervention, a need for help with other social determinants and more emotional support. Conclusions: This study shows that the program was well received and reveals the importance of addressing social determinants of health and behavioral health concerns.

Keywords: Asthma; community health workers; home-visiting; patient experiences; social determinants of health.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Asthma / diagnosis
  • Asthma / therapy*
  • Boston
  • Child
  • Community Health Workers / organization & administration*
  • Female
  • Health Care Surveys
  • Health Education / organization & administration
  • House Calls / statistics & numerical data*
  • Humans
  • Interviews as Topic*
  • Male
  • Parents / education*
  • Poverty
  • Program Development
  • Program Evaluation
  • Risk Assessment
  • Urban Population