Asthma Control: Home-Based Multi-Trigger, Multicomponent Environmental Interventions

Research Gaps

What are Research Gaps?

Prior to and during the literature review and data analysis, the review team and the Community Preventive Services Task Force attempt to address the key questions of what interventions work, for whom, under what conditions, and at what cost. Lack of sufficient information often leaves one or more of these questions unanswered. The Community Guide refers to these as "research gaps." Research gaps can be pulled together in the form of a basic set of questions to inform a research agenda for those in the field.

Identified Research Gaps

Effectiveness. The effectiveness of home-based multi-trigger, multi-component interventions has been established. Important questions still remain regarding the intervention composition and intensity as well as effectiveness in different settings and populations. Some of these questions include:

• What are the independent contributions of particular intervention components to overall intervention effectiveness? Which components are the most important for inclusion in this intervention?
• What is the required intensity (number of home visits, intensity of remediation, intensity of education) needed for an effective home intervention program?
• How does household member smoking impact the effects of this intervention? Should smoking cessation counseling be a necessary component of all home-based environmental interventions for asthma?

Applicability. This intervention has been studied most in low-income, urban minority populations but is most likely effective in most settings and populations. The following questions remain about the applicability of this intervention in various settings and populations:

• How effective is this intervention in adult populations?
• Are there differences in intervention effectiveness between children and adolescents?
• How effective is this intervention in rural populations?
• Is this intervention more effective in participants with more severe asthma symptoms?
• How does the type of dwelling (apartment, duplex, single family home) impact the effectiveness of the intervention?

Implementation. This intervention has been implemented in a variety of ways. However, questions still remain as to what is the most effective and cost-effective way to implement this intervention in a “real-world setting.” These questions include:

• How should this intervention be integrated in the health care system to insure appropriate access and sustainability?
• Which asthma patients should this intervention target?
• Who are the most effective intervention implementers (CHW, nurses respiratory therapist, etc.) and does this change depending on intervention setting?