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Common items in many homes, such as household cleaners, dust and animal dander, can trigger symptoms that make breathing difficult for people with asthma. These items are frequently found in the residences of in-home child care providers, and many such providers might be unaware that these triggers can cause asthma attacks.
That's where BWH's Jacqueline Rodriguez-Louis, MPH, MEd, comes in. As program coordinator at the Partners Asthma Center, a comprehensive care center for patients with asthma and related diseases, Rodriguez-Louis educates Boston's in-home child care providers about creating a safe, healthy environment for children and families who rely on their services.
To achieve this goal, Rodriguez-Louis came together in 2010 with Davida Andelman, a project director at Health Resources in Action in Boston, and Josephine Santana, a lead poisoning program coordinator at the Boston Public Health Commission. The creation of a "Healthy Homes Curriculum" geared toward in-home child care providers was the result of that partnership.
"As part of the program, we aim to educate providers about making their homes healthy and safe for children through three-hour training sessions and fact sheets, which are in providers' native languages," said Rodriguez-Louis. "Many of the child care providers we train are members of diverse, minority communities, including Latinos and African-Americans. Asthma rates tend to be higher in minority populations, and before the Healthy Homes Curriculum, these local populations were not receiving resources about asthma and lead poisoning prevention. We have made great progress."
Asthma rates also tend to be higher in lower-income neighborhoods. "Lower-income neighborhoods with public housing and low-income housing are often riddled with asthma triggers, such as worn carpeting, pest infestation, mold and poor ventilation," said Rodriguez-Louis. "Pollution, densely clustered businesses, diesel busses and dry cleaners in the neighborhood all emit chemicals into the environment that can trigger asthma symptoms."
In reducing asthma triggers, much of the focus was on the home environment. With the implementation of the curriculum, the perspective has expanded into other indoor environments, said BWH's Christopher Fanta, MD, director of Partners Asthma Center. "We are now starting to broaden our perspective by adding the child care environment where young children spend much of their day," said Fanta. "The impact on the asthma control of these children is likely to be very favorable."
Healthy Homes has provided training for 350 to 400 licensed in-home child care providers in the Boston area and surrounding communities. "Our main mission is to help those in-home day care providers create a healthy home for the children they care for," Andelman said. "This means having a home that is free of fragrances and harsh chemicals, lead paint, pests, mold, mildew and smoke."