Omaha Healthy Kids Alliance, Asthma In-Home Response Program

Omaha Healthy Kids Alliance (OHKA) is a children’s environmental health organization dedicated to improving children’s health through fostering healthy homes. OHKA developed the Asthma In-Home Response (Project AIR) program to serve children ages 18 and younger who have an asthma or asthma-related diagnosis.

Project AIR’s mission is to help reduce in-home hazards for children with asthma in the Omaha metropolitan area. By reducing in-home hazards, AIR works to improve the quality of life for children with asthma and their families by educating them on indoor environmental asthma triggers, empowering positive behavior changes, connecting them with low-cost supportive solutions, and supporting them by providing free construction services. Project AIR aims to reduce emergency department visits and hospitalizations resulting from pediatric asthma, decrease symptomatic days, improve quality of life for children and their families, and increase productivity by reducing asthma-related missed school and work days.

OHKA serves a population that is disproportionately affected by specific health outcomes and faces additional socioeconomic barriers that often take precedence over the intended Project AIR intervention. Most families in Project AIR tend to identify as Black/African American, with the second most frequent racial self-identification being Latino/Hispanic and the third most frequent group being Caucasian. The average household income of Project AIR clients is about $26,000, and the average age of houses that Project AIR families live in is 75 years old. OHKA has a wide network of community partners that assist families with challenges not directly related to their health. Assistance includes help with landlord-tenant disputes, rental assistance, job placement and food pantries. OHKA’s work is successful because of the collaborations and partnerships that have been established to assist in reducing barriers for families enrolled in Project AIR so that they are able to focus on health-related interventions.

OHKA’s Project AIR leverages key partnerships with WellCare of Nebraska (part of the managed care organization, WellCare® Health Plans, Inc.), Children’s Hospital & Medical Center (Omaha), and Boys Town National Research Hospital’s Allergy, Asthma, Immunology and Pediatric Pulmonary Clinics. In addition to formal partnerships, Project AIR provides an assigned asthma case manager, and in-home visits are performed by two OHKA staff who are trained in environmental management and asthma education. After the initial visit, each family receives a Healthy Home Report that is developed by the visiting team. This report includes a description of the home, identified home hazards, low-cost solutions, results of environmental testing and construction, and scopes of work. This document can be shared with physicians, if requested and approved by the family. In addition to a customized environmental supply kit, families often are referred to community organizations for legal and employment services or food pantry access.

Project AIR evaluates the program performance outcomes under four criteria: severity of asthma, quality of life, environmental health of the home, and behavioral changes. To assess how and where the program can be improved, Project AIR also examines internal measures, such as cost per intervention, cost of supplies, follow-up rate and dual-enrollment rate. After 12 months, Project AIR noted a significant decrease in symptomatic days, fewer missed school days, fewer emergency room visits and hospitalization rates, and a decrease in medication usage. Additionally, an evaluation of Project AIR return on investment showed for every $1 invested in a family and their home, a $1.83 return was made.

Project AIR integrates a collaborative approach to asthma intervention and diverse funding sources to create positive change in the Omaha metropolitan area. The program’s success has introduced new partnerships and improved outcomes throughout the asthma community.