were recruited from presentations in community centers, schools, and health fairs. Ninety four families with children younger than 14 years of age having at least one child with asthma, respiratory allergies, or sensitivities, were visited twice at their convenience with an average of 6-7 weeks apart.The approach of this project included using popular learning techniques while conducting an assessment to tailor the education, delivering of successful printed tools to reinforce information, and providing personal support from recognized and supportive members of the community, known as promotoras, also known as community health workers or lay health advisors.
Household, Environment, and Health
Our Promotoras asked families information about potential household environmental risks such as indoor air quality, outdoor air quality, allergens and asthma, pest and pesticide residues, lead, mold and moisture, water, household hazardous and hygiene products and household practices. These topics were included according to recent research findings about the most important risks that can be found in homes and because these pollutants can become a risk for the health of the children. Additionally, the project included recommendations by the Environmental Protection Agency (http://www.epa.gov/) and the Centers for Disease Control and Prevention (http://www.cdc.gov/) agencies.
Click here for Children’s Health Protection Information from the Environmental Protection Agency: http://yosemite.epa.gov/ochp/ochpweb.nsf/content/homepage.htm
Questions to Address Household Environmental Risks
A questionnaire was used to assess knowledge gaps and determine appropriate recommendations. Questions were based on the Healthy Environments and Living Places for Kids module (H.E.L.P. for kids) from the Indoor Air Quality Section of EPA Region 6. The Home Environmental Review Checklist and the Home Recommendations List were thoroughly reviewed considering local cultural characteristics and practices.
Answers from the checklist were used to tailor the education with information provided in the Home Recommendations List. The checklist and the recommendation list were linked by a number. The checklist was completed also at the follow up visit to compare changes. To reinforce the information, educational booklets and comic books were distributed and environmentally safer products were demonstrated (see Diagram 1).
Culturally Appropriate Materials for the Paso del Norte Region
Promotoras distributed printed materials to reinforce the information provided during the visits and to assure continual fortification of lessons learned. The purpose of the comic books was two-fold: to use them as a learning tool while providing recommendations and to assure continual reinforcement. Comic books had been a proven tool to transfer scientific environmental health information to low literacy-Spanish speakers at the border. See table 2 for the list of materials distributed during this project.
Click here to download the comic books developed by CERM (NOTE: see list from CERM). These materials include easy and clear recipes with environmentally safer products.
Safer Products for Children and the Environment
At the end of each visit promotoras delivered safer cleaning and pest management products in a “healthy kit” (See Table 2). Healthy kit products were used both as a learning practice and as compensation to participants. Products such as vinegar and borax were used to explain how to clean surfaces and stoves, and mouse and glue traps were mounted behind the furniture to catch pests. Additionally, safety devices (outlet caps and cabinet locks) were set up and a carbon monoxide alarm was installed to prevent poisonings. Ambient, refrigerator, and tap hot water thermometers were used while families learned adequate temperatures to prevent moisture and mold growth in rooms and refrigerator, and to kill dust mites and bacteria in clothes washing. Information on how to use the “healthy kit” products can be found in the “culturally appropriate materials” section.