THE CAMBRIDGE-SOMERVILLE HEALTHY HOMES PROGRAM

The Women’s and Children’s team invited social service staff to a recent presentation on the Cambridge-Somerville Healthy Homes (CSHH) program that provides Pediatric asthma education and prevention in the home. Alicia Morris, RN, BSN, AE-C, Certified Asthma Educator, described their services.

Cambridge-Somerville Healthy Homes, a program of Cambridge Health Alliance, provides pediatric asthma education and intervention as well as childhood lead-poisoning prevention. Services are funded by Cambridge Health Alliance, DPH, and Network Health has partnered on a pilot fee-for-service program. An RN and Community Health Worker make alternate visits to the home about 5 times over a 6 month period to provide environmental assessment and teaching about environmental triggers, prevention and treating asthma. Ms. Morris opened with some basic asthma education- similar to what she provides to patients and families. She discussed some possible causes and associations such as dust mites, cockroaches, tobacco smoke, RSV and family background/genetic causes. She explained asthma “triggers”, environmental or other factors that may initiate an asthma attack. Common triggers include pets, tobacco smoke, exertion, cold weather, dust, strong emotions and strong odors or sprays.

Using a model of the airway she demonstrated the physical changes that occur during an asthma attack as she’d explain it to a patient and family. She then explained that most people with asthma need two types of medicines. First there is a preventative/controller medicine that is taken daily to protect the lungs and to keep an asthma attack from starting. The second medicine is used only when needed, to offer quick relief and stop an asthma attack that is underway. Many families are confused about the two types of medication, and it is not uncommon for them to administer them erratically or improperly (one parent even reversed the medications), which then renders them less effective. Because staff are able to spend the necessary time required for thorough teaching, the program often serves to bridge the gap between the clinic and the home.

Services
The Healthy Homes program is the only one of its kind in the area and there are no charges to families for these services. They provide home assessments, parental education, products that help reduce asthma triggers (e.g., mattress or pillow covers protect from the allergenic effects of dust mites) or help improve home safety, social support and community education. They may offer indoor air quality testing and frequently serve as a liaison between tenants and landlords to help clarify what needs to be done to resolve a health hazard, and the most efficient way to address the issues.

Parental education might include explaining hazards and hazard reduction techniques, providing translated materials, teaching and trouble-shooting medication use and the family’s asthma management plan. Families often have concerns about reporting hazards for fear of losing their housing, so one intervention might be to explain their rights and walk them through the process.

Eligibility:

On occasion, if time allows, they may be able to offer asthma services to families with children over 13 years old, or who live in other communities.

There is only one other such program in the state of which Ms. Morris is familiar- a program through the Boston Public Health Commission that focuses primarily on the environmental issues, but is unable to provide clinical services.

For more information, see program brochure (2013).

Contact Information:

12/07, Rev. 4/19