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Master Home Environmentalist program

Health Factors: Built Environment
Decision Makers: Government - Local, Healthcare Organizations
Evidence Rating: Some Evidence
Population Reach: 50-99% of WI's population
Impact on Disparities: Likely to decrease disparities

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Description

The Master Home Environmentalist © program, started by the Washington American Lung Association®, trains volunteers to assist residents in assessing and remediating environmental health risks within the home. Volunteers often recommend low cost changes such as improved ventilation, integrated pest management, and other forms of allergen control. These changes are expected to alleviate or prevent health conditions due to substandard housing (ALA MHE Program). 

Expected Beneficial Outcomes

Improved indoor air quality
Improved health outcomes

Evidence of Effectiveness

There is some evidence that the Master Home Environmentalist Program (MHEP) and similar home intervention programs encourage household behaviors that reduce asthma triggers and exposure to allergens (Leung 1997, Primomo 2006, Postma 2011, Hoppin 2006, Takaro 2004). Additional evidence is needed to confirm effects on health outcomes, particularly asthma and respiratory conditions (Krieger 2002).

Home visitations by asthma outreach workers and MHEP trained coaches enhance asthma self-management capabilities and improve quality of life (Primomo 2006). Available research suggests that MHEPs are more established in urban areas, although MHEP home visitations have also been shown to improve home air quality and reduce urgent care admissions for rural, Latino families in some circumstances (Postma 2011). A review of public health department programs suggests that home visit interventions improve asthma symptoms, especially for those living in low quality housing units (Hoppin 2006).

The EPA recognized the MHEP with a Children's Environmental Health Excellence Award in 2005 (US EPA-Awards 2005).

Implementation Examples

United States

The Master Home Environmentalist Program started in Washington and has expanded to the American Lung Associations of Oregon, Central California, North Dakota, Rhode Island, Metropolitan Chicago, and Santa Clara-San Benito Counties. The program is also in place in the Idaho Division of Health, Chelan Douglas Health Department (WA), The Confederated Tribes of the Colville Reservation, Okanagan Public Health Department (WA), Thurston County Health Department (WA), The George Washington University of Public Health and Health Services; Mid Atlantic Center for Children's Health, Metropolitan Health District of San Antonio, Texas, the New York City Health Hospital Corporation and the Woodhull Hospital Asthma Program (ALA MHE Program).

Implementation Resources

ALA MHE Program - American Lung Association (ALA). The Master Home Environmentalist (MHE) program. Accessed on June 20, 2012
Webpage: http://www.lungusa.org/associations/states/washington/local-programs/air-quality/master-home-environmentalist
Clean Air HEAL - Clean Air for Kids Partnership. Directions for the do-it-yourself home environmental assessment list (HEAL). Accessed on June 23, 2012
Webpage: http://www.tpchd.org/files/library/0aa73e5da1c29d0f.pdf

Citations - Description

ALA MHE Program - American Lung Association (ALA). The Master Home Environmentalist (MHE) program. Accessed on June 20, 2012
Webpage: http://www.lungusa.org/associations/states/washington/local-programs/air-quality/master-home-environmentalist

Citations - Evidence

Hoppin 2006 - Hoppin P, Jacobs M, Ribble M. Enhancing asthma management using in-home environmental interventions: A review of public health department programs. Dorchester: Asthma Regional Council of New England (ARC); 2006. Accessed on June 20, 2012
Webpage: http://www.nchh.org/Portals/0/Contents/Coalition_ARC_In-Home_Environmental_Interventions.pdf
Krieger 2002 - Krieger J, Takaro TK, Allen C, et al. The Seattle–King County Healthy Homes Project: Implementation of a comprehensive approach to improving indoor environmental quality for low-income children with asthma. Environmental Health Perspectives. 2002;110(Suppl 2):311-22. Accessed on June 20, 2012
Webpage: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1241178/pdf/ehp110s-000311.pdf
Leung 1997 - Leung R, Koenig JQ, Simcox N, et al. Behavioral changes following participation in a home health promotion program in King County, Washington. Environmental Health Perspectives. 1997;105(10):1132-35. Accessed on June 20, 2012
Webpage: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1470377/pdf/envhper00323-0114.pdf
Postma 2011 - Postma JM, Smalley K, Ybarra V, Kieckhefer G. The feasibility and acceptability of a home-visitation, asthma education program in a rural, latino/a population. Journal of Asthma. 2011;48(2):139-46.
Accessed on June 20, 2012
Webpage: http://www.ncbi.nlm.nih.gov/pubmed/21043988
Primomo 2006* - Primomo J, Johnston S, DiBiase F, Nodolf J, Noren L. Evaluation of a community-based outreach worker program for children with asthma. Public Health Nursing. 2006;23(3):234-41.
Accessed on June 19, 2012
Webpage: http://onlinelibrary.wiley.com/doi/10.1111/j.1525-1446.2006.230306.x/abstract
Takaro 2004 - Takaro TK, Krieger JW, Song L. Effect of environmental interventions to reduce exposure to asthma triggers in homes of low-income children in Seattle. Journal of Exposure Analysis and Environmental Epidemiology. 2004;14(Suppl 1):S133-43. Accessed on June 20, 2012
Webpage: http://www.nature.com/jes/journal/v14/n1s/full/7500367a.html
US EPA-Awards 2005 - US Environmental Protection Agency (US EPA). 2005 Children’s environmental health excellence and recognition awards. Accessed on June 23, 2012
Webpage: http://yosemite.epa.gov/ochp/ochpweb.nsf/content/2005_CEH_Awards.htm

Citations - Implementation Examples

ALA MHE Program - American Lung Association (ALA). The Master Home Environmentalist (MHE) program. Accessed on June 20, 2012
Webpage: http://www.lungusa.org/associations/states/washington/local-programs/air-quality/master-home-environmentalist

* Journal subscription may be required for access.

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Evidence Rating

Level of effectiveness based on a scan of academic literature and key recommendations of leading organizations.

  • Scientifically Supported Numerous studies or systematic review(s) with positive results
  • Some Evidence Research suggests positive impacts; further study may be warranted
  • Expert Opinion Recommended by credible groups*; research evidence limited
  • Insufficient Evidence Evidence limited or unavailable; further study warranted
  • Mixed Evidence Evidence mixed; further study warranted
  • Evidence of Ineffectiveness Research consistently shows program is detrimental or has no effect

Although many policies and programs are recommended by credible groups, we apply the rating ‘expert opinion’ only when policies are recommended but limited scientific evidence of effectiveness is available.

* The American Heritage Dictionary defines credible as 'capable of being believed; plausible.' and 'worthy of confidence; reliable.' To be considered an 'expert recommendation,' policies and programs must be recommended by one or more organizations that are recognized for their impartial expertise in the area of interest and have limited evidence available.

Potential Population Reach

Portion of Wisconsin's population likely to be reached by a policy or program if implemented statewide, based on its characteristics (e.g., target population(s), geographic limitations, and potential implementers).

<1%   20-49%
1-9%   50-99%
10-19%   100%

Potential Population Reach

Portion of Wisconsin's population likely to be reached by a policy or program if implemented statewide, based on its characteristics (e.g., target population(s), geographic limitations, and potential implementers).

<1%   20-49%
1-9%   50-99%
10-19%   100%

Potential Impact on Health Disparities

Likely impact of a given policy or program on racial/ethnic, socioeconomic, geographic or other disparities in Wisconsin based on its characteristics (e.g., target audience, mode of delivery, etc.) and best available evidence related to disparities.

  • Likely to decrease disparities
  • No impact on disparities likely
  • Likely to increase disparities