Putting on AIRS (Asthma Indoor Risk Strategies)

410 Capitol Ave, MS 11 HLS
06134 Hartford , CT
State of Connecticut, Department of Publicl Health CDC funded in-home asthma program focusing on patient/family self-management asthma education and identification and mitigation of environmental exposures that exacerbate asthma in order to reduce asthma-related adverse events.

The in-home asthma program is implemented regionally throughout Connecticut, local health departments are contracted by the CT Dept of Public Health with CDC funds to perform the in home asthma visits. Currently, six of seven CT Dept Public Health Asthma Program defined regions in Connecticut have a Putting on AIRS program including: New Haven/Milford, New London/Groton/Norwich, Northeast District Department of Public Health, Central CT Health District/Hartford, Naugatuck Valley Health District, and Stratford Health Department/Bridgeport.


The objective of this statewide program is to reduce acute asthma episodes and improve asthma control through patient/family self-management education and recognition and elimination/reduction of environmental and other asthma triggers in six asthma regions.

Home Visit Details

There are two main parts to the Putting on AIRS home visit: patient/family self-management asthma education and environmental assessment.  An asthma educator/nurse/respiratory therapist with experience in asthma management and an environmental specialist, such as a sanitarian, staff the visit.  Given the regional approach to program implementation, often the asthma educator and the environmental specialist may be from different towns. All staff members receive formal Putting on AIRS training conducted by CT DPH or another experienced asthma region.  A train-the-trainer approach is used for subsequent personnel needing training in a specific region. All educators also attend the American Lung Association’s Asthma Educator Institute two-day training.


The program consists of an initial visit and three telephone follow-up encounters.  Additional visits may also be provided, depending on the status of the program participant at the last encounter.


  • Initial Visit:  After the asthma project nurse administers an intake questionnaire with the participant/caregiver via telephone, a home visit is scheduled.  The asthma project educator/nurse/respiratory therapist  and environmental specialist both participate in the initial home visit.  The nurse administers a home assessment questionnaire that captures baseline data on knowledge of asthma triggers.  The nurse collects additional baseline data regarding missed school days, emergency department visits due to asthma; asthma-related physician visits in the previous month, medication usage and technique, and current asthma action plan and begins a dialogue with the participant about issues and questions.  Both the educator/nurse/respiratory therapist and the environmental specialist conduct a walk-through of the home, assessing and recording sources of environmental triggers for asthma.  Results from the home assessment inform an environmental summary care plan which outlines low or no-cost options to reduce or eliminate the trigger sources.  The environmental summary care plan is discussed with the participant. At the end of the visit, the participant/caregiver retakes the home assessment questionnaire regarding knowledge of asthma triggers for the purpose of post assessment evaluation.  Staff leave a folder of educational information with the participant containing various brochures/fact sheets including: “Helping Your Child Manage Asthma: A Parent Handbook,” “What Everyone Should Know About Asthma,” and “Controlling Asthma and Allergies in Your Home,” as well as an asthma action plan and fact sheets on medications specific to the participant. 
  • Depending on funding or donations, the program may also provide pillow/mattress covers, spacers and peak flow meters.  EPA funds currently support purchase of the equipment.  Subsequent to the visit, an in-home evaluation summary with action recommendations is completed and sent to the participant (or caregiver) and the participant’s medical providers (i.e. primary care physician, school nurse, asthma specialist, school health services, school-based health center)
  • 2-Week Follow-up:  At two weeks, the asthma project educator/nurse/respiratory therapist  follows up with the participant either by telephone.  The nature of the follow-up is to evaluate the participant’s frequency of asthma symptoms and progress regarding the recommendations suggested on the In-Home Evaluation Summary.  The in-home assessment questionnaire on knowledge of asthma triggers is administered again and the results are discussed.
  • 3-Month Follow-up: At three months, the asthma project educator/nurse/respiratory therapist  contacts the participant to review the progress in implementing the care plan.  The nurse offers recommendations and answers questions and concerns.   The educator/nurse/respiratory therapist  collects final data regarding number of missed days of school, emergency room visits, and asthma-related physician visits since the Putting on AIRS initial visit.  In addition, knowledge of asthma triggers is again evaluated and discussed.  A program evaluation form is left with the patient with a self-addressed stamped envelope to gather feedback about the program.
  • 6-Months Follow-up:  At six months, the asthma project educator/nurse/respiratory therapist  is encouraged to make a final follow-up call to determine if any additional follow up or answers to questions are needed.


Elements of the home visits described above are detailed in the Putting on AIRS implementation protocol.  The protocol is part of the CTDPH’s Putting on AIRS program implementation guide, which is made available to all participating health departments on CD ROM and on their web site at http://www.ct.gov/dph/asthma .  The guide contains background information on the program:

·         how to get started (i.e. assembling the in-home staff, supply and training needs, etc.)

·         templates for all forms, questionnaire, summaries etc.

·         asthma education topics to be covered and tips on how to effectively deliver the education

·         program promotion and marketing materials

·         a template MS Access database for data collection and analysis.


Program Outcomes

The Program is in its sixth year of regional implementation for the home visits.  Data is collected annually from the 6 regional programs, including number of home visits, pre/post data on knowledge of asthma triggers, number of missed days of school, emergency room visits, and asthma-related physician visits.




Contact Information

Connecticut Department of Public Health

Putting on Airs Program

Eileen Boulay, Project Director