Waiting to Breathe Freely: CHOP Tackles Asthma Triggers in Homes
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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 a new, 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 renovations, 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 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.
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But sometimes, community health workers see probable causes of triggers that go beyond their ability to 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.
That’s where CAPP+ steps in. A collaboration between CHOP and the Philadelphia Housing Development Corp. (PHDC) — 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 and code 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.
In addition to being the No. 1 noninjury reason for kids’ emergency department visits, asthma is 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 percent,” 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.”
That expectation led CHOP to invest initially in repairs to 10 homes as a pilot, thanks to a generous donation from the Otto Haas Charitable Trust. Given the success of the pilot, the hospital announced it will fund the expansion of the program to repair up 100 homes over the next year, with more to come over the next four years. Asthma outcomes of participating children will be measured to track CAPP+’s impact. Included in CAPP+ is a requirement that PHDC hire local minority- and women-owned contractors and purchase supplies, when possible, within the city of Philadelphia to advance CHOP’s commitment to economic inclusion.
The CAPP+ program allows us to give underrepresented small business owners and contractors a chance work on a long-term project of major significance in our community,” says Peter Grollman, Senior Vice President of External Affairs. “By making these repairs, they can benefit from a new economic opportunity while joining us in our efforts to improve the overall health of children in Philadelphia.”
Sheila Adkins, CEO of Adkins Management, a minority-certified construction company that renovated the Stevenson home, says, “We've done work for other PHDC programs, except now we're going to change the quality of life for children, which really excites me. Addressing things that could cause or trigger asthma attacks for little kids is very, very special.”
CAPP+ is one of three CHOP programs under the umbrella of Healthier Together, a community initiative that will also tackle food insecurity and access to mental and behavioral health services in West Philadelphia neighborhoods. Children’s Hospital, with the help of donors and volunteers, operates more than 100 community programs, working with other nonprofits and government agencies to improve the overall health and well-being of children.
While these innovative CHOP programs stand to have a significant impact for greater Philadelphia, for the Stevenson family, it’s personal.
“What makes the CAPP+ program so amazing is the heartfelt genuineness of it,” says Stevenson. “It was all about, ‘How can we make this better for you and your family?’ There’s no judgment. It was only, ‘This could be a problem, so let’s fix it.’ It’s all about how to improve your child’s health, which is fantastic.”
Watch the following video to learn more about how CAPP+ is making a difference for children like Shai.