Member Spotlight: Expansion of the Springfield Healthy Homes Asthma Program

Community Health Workers organize home visits with patients and their families

A Healthy Homes Professional completes a comprehensive home assessment for environmental hazards and if asthma related home repairs/services are identified, Revitalize CDC will make the repairs and provide support

Patients receive educational packet as well as supplies such as anti-allergen pillow/bed protectors, and green cleaning kits.

Carpeted staircase removed as an asthma trigger

Regrettably, Springfield, MA has been designated  the top Asthma Capital for the second year in a row by the Asthma and Allergy Foundation of America. It is one of 100 most challenging place to live in with asthma, in the nation. Many unfavorable circumstances contribute to the greater Springfield area’s high asthma prevalence and burden, including:

• Geographical location in a valley where both pollen and carbon dioxide collect;

• Heavy interstate traffic and commercial pollution;

• Old housing stock;

• Lack of access to short- and long-term healthcare services; and

• Poverty.

The Springfield community has a long history of combating asthma, and over the years, has been able to develop diverse partnerships, combine resources and build capacity to address the high rates of asthma. Most recently, Baystate Health Care Alliance/BeHealthy Partnership ACO received a SHIFT-Care Challenge grant award from the Health Policy Commission to expand the Springfield Healthy Homes Asthma Program. The program’s goal is to improve the quality of life for people living with asthma and reduce asthma health care costs by reducing hospitalization and emergency department visits through implementation of an evidence-based home visiting and home remediation service.

The health and housing sectors have been working together for many years but have not had significant funding to do something at a broader level. This new funding brings partners together to form an innovative collaborative to implement an evidence-based intervention. BeHealthy Partnership, an Accountable Care Organization, is joining together with community organizations from the greater Springfield area to refer patients for the Springfield Healthy Homes Asthma Program’s home education and remediation services. Revitalize Community Development Corporation is the lead housing service provider that will be providing critical repairs and rehabilitation to homes with additional support and services from other community partners. Other partners in the collaborative include:

• University of Massachusetts Medical School – Baystate;

• Public Health Institute of Western Massachusetts;

• Pioneer Valley Asthma Coalition;

• Baystate Medical Center’s Pulmonary Rehabilitation Department;

• City of Springfield Office of Housing;

• Springfield Partners for Community Action; and

• Green & Healthy Homes Initiative.

The expansion of the Springfield Healthy Homes Asthma Program will serve 150 families with home-based asthma education and self-management support (e.g., proper use of medications), as well as home assessment and repair for conditions that contribute to asthma flare-ups. The new funding enables Baystate’s Pulmonary Rehabilitation Department to hire two community health workers to conduct the home visits and asthma education. Over the 18-month project, patients will receive 3-4 home visits and families will also receive supplies such as anti-allergen pillows, mattress protectors, and green cleaning kits. BeHealthy Partnership patients who have been hospitalized or have had multiple emergency room visits in the last year for asthma, are eligible for the services.

Springfield has one of the largest and oldest housing stocks with a high need for remediations. The cost of housing repairs and maintenance can be prohibitive for families and overtime the housing stock has significantly deteriorated due to moisture, mold, pests and other housing conditions that can trigger asthma and lead to other health problems. Through the expansion of the Springfield Healthy Homes Asthma Program, the collaborative is hoping to address unhealthy homes as one of the root causes of poor asthma outcomes. Through a series of data collection and evaluation, they are hoping to show the sustainability of this intervention and make the case to keep it going. By leveraging its community assets and persistence in combating poor asthma outcomes, Springfield has become an active leader in mobilizing communities and continues to find innovative ways to improve asthma outcomes for families.

Congratulations Springfield!

Member Spotlight: Parent Asthma Network

October 24, 2018, the first PAN session ABCD Geneva Avenue. Participants heard from Alexa Down, M. ED and Moussa Cisse (ABCD Health and Nutrition Services Managers) about the importance of having healthier options and the role as service managers as it relates to asthma and nutrition at the childcare center. Participants also learned about local food resources such as Fresh Truck, Fair Foods, SNAP, and other affordable food resources in Boston.

December 20, 2018, the PALS’s First Annual Holiday Dinner. The Injury Prevention, Oral Health, Asthma Control and Tobacco Control programs, Health Resources in Action, as well as the Mayor’s Health Line donated 50 gifts to be distributed among the ten families in attendance. The PALs were also presented with certificates of appreciation from the Boston Public Health Commission for their leadership and advocacy.

January 9, 2019, 4th PAN session at the ABCD Geneva site with ten participants. Mrs. Nancy Smith from the Public Health Preparedness office presented to the PAN participants.

March 19, 2019, Quincy Roberts from Office of Fair Housing and Equity spoke to parents about his department and all housing issues.

March 19, 2019, Nathalie Bazil from Healthy Homes, Massachusetts Department of Public Health and JSI Research & Training Institute, Inc. (JSI) held a focus group during the Parent Asthma Network session to better understand factors that can affect health and quality of life for persons with asthma. In addition the responses gather from the participants will help to better understand what steps can be taken to prevent and better control asthma, as well as to support those affected by the disease. These action steps might be included the next five-year State Plan for Preventing and Controlling Asthma in MA.

Parents and Youth Taking Control of the Asthma Epidemic in Boston

Background: The Boston Public Health Commission (BPHC) created the Parent Asthma Network (PAN) to develop a support network for and between parents/caregivers who may be facing similar successes and challenges in managing asthma. PAN participants can connect with others who live in the same vicinity and increase their ability to provide each other with critical peer support.

Over the decades, BPHC has been a leader in convening community and key stakeholders to address the root causes of Boston’s heavy asthma burden as well as model prevention and control initiatives. Even though there have been tremendous medical advances in asthma control, and much is now known about medical and non-medical ways to prevent and control asthma, there is still opportunity for more to be done. Asthma rates, emergency room visits, hospitalization stays and deaths due to asthma persist at an unacceptably high rate. Asthma remains a complex issue and can be very confusing for anyone to understand and manage. While BPHC, partner agencies and community members continue working to address the systemic and environmental contributors to asthma, we also need to ensure the immediate burden at hand is being addressed.

PAN Overview: Through PAN and related initiatives, BPHC’s goal is to ensure the wide spread of accurate information about asthma, encourage individuals and communities to learn about and use effective asthma management practices, and make use of the numerous resources and supports available throughout Boston. PAN was piloted from the Fall of 2017 to Spring 2018 with great interest and success and continues with funding support from the MA Department of Public Health (MDPH). MDPH and BPHC’s seasoned community health workers (CHWs) provide key mentorship and three experienced Parent Asthma Leaders (PALs) through Health Resources in Action (HRiA) also provide support. To date, PAN has engaged over 150 individuals. BPHC aims to expand the network of parents and support the training of more PALs who can be a resource to their communities and networks.

How PAN Works: PAN is run as facilitated group sessions that focus on key topic areas with guest speakers and opportunities for sharing experiences and ideas. PAN sessions are currently being hosted by the ABCD Head Start Geneva Ave site in Dorchester and East Boston Neighborhood Health Center (run in Spanish).  Each site runs multiple sessions during the academic year and features a range of topics and activities, including asthma basics, asthma medication, asthma and nutrition, asthma and back to school prep, asthma and environmental health, MassHealth/asthma, and emergency preparedness.

During these sessions, participants learn from each other and dialogue with guest speakers from agencies including Boston Inspectional Services, BPHC’s Office of Public Health Preparedness and the Mayor’s Health Line, East Boston Neighborhood Health Center, and Partners Asthma Center.

A pre/post-quiz is given to participants at the beginning and end of each session to help them in their learning process. An evaluation is conducted at the end of each session to ensure participants are contributing to the design and shape of successful meetings and activities. Participants also get to voice what topics they would like to see at future sessions.

When asked what they found most meaningful about workshops, participants said:

“Now I have a better understanding of the asthma action plan. I find this information useful and appropriate. Thank you.” – PAN participant

“There was time for questions and answers, love this workshop well informed, other parents, much knowledge was shared in this room. Thank you!” – PAN participant

“Great workshop. Very interesting and interesting topic” – PAN participant

PAN was conceived and is coordinated by Nathalie Bazil, BSW, CCHW, Senior CHW and Coordinator for the BPHC Asthma Prevention and Control Program. The three PALs from HRiA are also instrumental in the success of PAN. The PALs are dedicated members of the community who took a stand over 20 years ago to ensure the city was taking responsibility for the high asthma rates in Boston. Since then, the PALs have been part of efforts and conversations with a range of key city agencies and sit on numerous advisory boards. Through PAN, BPHC hopes to see a new generation of PALs who can be mentored by the current representatives. PAN has been a tremendous success, and we hope to see it only expand further into communities as an effective model for collective awareness and action. BPHC is currently working with partners on a new network for and by youth and young adults. For more information contact asthma@bphc.org.