A new partnership with the city enables no-cost home repairs to reduce asthma triggers.

Mother and daughter sitting together When Shaneena Stevenson gives a tour of her recently renovated home, the superlatives flow like water. “Stupendous. Great. So nice. Like a brand-new house. Wow.”

Her 4-year-old daughter, Shai, pipes up with the best description of all: “Sparkly!”

The Stevensons are enjoying a gleaming new bathroom, kitchen, living room ceiling and basement flooring, thanks to renovations available through an innovative program from Children’s Hospital of Philadelphia, CAPP+. Those areas had been laden with mold from longstanding plumbing problems and were making Shai’s asthma worse. 

Since the repairs, done at no cost to the family, Shai hasn’t had an asthma flare. “She’s been able to just take her regular preventive medicine and hasn’t needed her rescue inhaler,” Stevenson says. “I’ve definitely seen an improvement.”

That is exactly the goal of CAPP+, an extension of CHOP’s 20-year-old Community Asthma Prevention Program (CAPP). CAPP gives families that struggle to manage their child’s asthma extra support with education and help minimizing asthma triggers — environmental causes of asthma flares or attacks — in their homes. A specially trained community health worker (CHW) visits the home and might advise removing carpet in the child’s bedroom, demonstrate trigger-preventing cleaning techniques, discuss pest control, or convince a child to keep one favorite stuffed animal instead of an entire menagerie. 

Sharing info is critical

But sometimes, CHWs see probable causes of triggers that go beyond a simple fix. Most common is water damage — from leaky roofs, pipes or drainage systems — that leads to mold and mildew. Also prevalent are pest problems due to unsealed openings. These are repairs families don’t have the skills or the money to fix, leaving their children at increased risk for asthma attacks.

Side by side of old and new cabinets The Stevenson's kitchen before and after the CAPP+ repairs That’s where CAPP+ steps in. A collaboration between CHOP and a city nonprofit program that provides free home repairs and handicap accessible modifications for low-income Philadelphians, CAPP+ fixes those bigger problems.

“CAPP+ would not be a reality if it weren’t for a partnership between Children’s Hospital of Philadelphia and the city of Philadelphia,” says CHOP President and CEO Madeline Bell. “We bring the health expertise, and they bring the housing expertise. Together, this makes a great partnership.”

“It’s going to give kids an environment to live in that gives them a fighting chance at having a better life than they have now,” adds Philadelphia Mayor Jim Kenney.

Asthma: the big disrupter

Asthma is the No. 1 noninjury reason for kids’ emergency department visits and the leading health-related reason children miss school, and the accumulated missed days can have a lifelong impact. Parents often have to miss work, adding additional stress to low-income families.

We know that with CAPP alone, we see a reduction in hospitalizations by 48 to 50%,” says the program’s Medical Director, Tyra Bryant-Stephens, MD, “and we expect that to be even larger now that we're doing these major home repairs.

Asthma outcomes of participating children will be measured to track CAPP+’s impact. Included in CAPP+ is a requirement that local minority- and women-owned contractors are hired and supplies are purchased, when possible, within the city of Philadelphia to advance CHOP’s commitment to economic inclusion.

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