Tailored Environmental Interventions
Strategy 1 - Educate Care Teams on Environmental Management
Provide education to clinical care teams on environmental triggers, diagnosis of sensitivities, techniques for minimizing trigger exposure, patient education, and ways to refer patients for environmental services
Strategies in Action:
- UHP trains providers, health educators, and medical assistants to improve patient self-management by helping patients follow their action plans. All plans include trigger diagnoses and customized environmental management strategies.
- CAPP makes it easy for providers to refer patients for environmental education and home-visits and reports back to providers on the outcomes of in-home interventions.
Strategy 2 - Promote Assessment of Environmental Sensitivity and Exposures in Clinical Interviews
Promote skin and blood tests to assess environmental sensitivities, Guide teams on how to assess exposures through effective interviews that inquire about exposure to tobacco smoke, seasonal worsening of symptoms, etc.
Strategies in Action:
- Monroe’s Chief Medical Officer helped develop guidelines for asthma care that recommend clinical assessment of patients’ exposure to irritants and allergens and counseling on avoiding secondhand smoke. The guidelines indicate that skin testing is preferred, but not necessary; effective interviewing can provide accurate exposure information.
Strategy 3 - Provide Tailored Education and Counseling During Clinical Visits
Ensure care teams educate patients on how to identify, control, and avoid their environmental triggers, tailoring recommended interventions to individual sensitivities, Guide teams on how to assess exposures through effective interviews that inquire about exposure to tobacco smoke, seasonal worsening of symptoms, etc.
Strategies in Action:
- NYCAI promotes the use of individualized asthma action plans across their provider and plan network.
- UHP requires clinical care teams to deliver written plans that address environmental triggers—“writing it down for the patient makes the biggest difference…when it’s written down, the families can’t forget.”
Strategy 4 - Promote Environmental Trigger Management at Home, School, and Work
Partner with local service providers to provide home assessments and interventions, and to teach patients to manage home environments, Promote environmental asthma management in schools by educating school nurses, decision-makers, and parents about the risks of exposures at school, Partner with employers to educate adult patients and minimize exposures in the workplace
Strategies in Action:
- ANWM case managers work with families, schools, and health care providers to control environmental triggers. A medical social worker coordinates with housing officials, social service agencies, and property owners to address risks.
- CHA clinicians can refer patients to the local Healthy Homes program for home visits and the Healthy Homes staff has access to CHA’s asthma registry where they can report on home visit findings.
- CAPP trained all school nurses in North and West Philadelphia on environmental asthma management techniques for schools.
- The AH! Program partners with a large employer, Barber Foods, to provide on-site asthma education on minimizing workplace exposures.