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Your Environment. Your Health.

Outcomes of a home-based environmental remediation for urban children with asthma

Environmental Health Economic Analysis Annotated Bibliography


Research article Cost-benefit analysis (CBA)
Bryant-Stephens T and Li Y
Journal of the National Medical Association
This study examined the effectiveness of a home-based intervention for reducing environmental asthma triggers, and determined that children experienced fewer asthma-related hospitalizations, emergency room visits, sick visits, and asthma symptoms with the intervention. Study findings suggested that low-cost in-home education and environmental remediation may improve outcomes for asthmatic children, and that lay educators can deliver effective asthma-specific education that results in improved asthma control.
Children and adolescents living in urban areas (2-16 years)

Health Outcomes

  • Respiratory outcomes (asthma, asthma symptoms (nighttime/daytime wheezing and coughing))

Environmental Agents

List of Environmental Agents:

  • Indoor allergens (cockroach, dust mite)
  • air pollutants (tobacco smoke)

Source of Environmental Agents:

  • Allergens from pests (cockroaches, rodents)
  • cigarette smoke (secondhand smoke)

Economic Evaluation / Methods and Source


  • Cost-benefit analysis (CBA)

Cost Measured:

  • Asthma-related inpatient hospitalizations (length of hospital stays)
  • number of emergency visits related to asthma
  • number of sick visits related to asthma
  • cost for environmental asthma trigger intervention
  • salary for home visitor

Potential Cost Measures: (Not available)

Benefits Measures:

  • Reduction in number of inpatient hospitalizations/visits
  • reduction in number of asthma-related emergency department visits and sick visits
  • reduction in frequency of daytime/nighttime asthma symptoms (wheezing, coughing, etc.)
  • reduced reliance on asthma medications (beta-agonists and controller medicines (e.g., albuterol))

Potential Benefits: (Not available)


  • Philadelphia, Pennsylvania

Models Used: (Not available)

Methods Used:

  • The authors used a prospective, randomized controlled trial design to study the effectiveness of a low-cost asthma intervention using lay educators to promote control of asthma triggers in the bedrooms of children with asthma. The authors — 1) enrolled patients in the study who received primary care at The Children's Hospital of Philadelphia between 1999 and 2002; 2) randomly assigned patients to either the observation only (OBS) group or the home visitor education and environmental intervention (HVE) group; 3) delivered in-home education visits which covered asthma physiology, asthma trigger avoidance and asthma management and conducted environmental remediation with the caregiver; and 4) monitored groups for 12 months.

Sources Used:

  • The authors collected the data used for the study described in this publication. No other existing datasets were used.

Economic Evaluation / Methods and Source


  • Bryant-Stephens T and Li Y. 2008. Outcomes of a home-based environmental remediation for urban children with asthma. Journal of the National Medical Association.


DOI: (Not available)

NIEHS Funding: (Not available)

Other Funding: (Not available)