The New York City Department of Health and Mental Hygiene and Montefiore Medical Center, with the Fund for Public Health of New York (FPHNY), DOHMH's fiscal agent, are partnering on a study to evaluate the feasibility, health outcomes and return-on-investment of a single, integrated pest management (IPM) intervention for Bronx, Harlem, and Northern Manhattan children aged 5 to 12 with persistent asthma who are living in homes with pests. By demonstrating cost effectiveness, this study could provide the basis for health insurance coverage of an IPM visit embedded in clinical treatment plans for high-risk asthma patients living with pests. Asthma is the most common childhood disease in New York City, and both prevalence and hospitalization rates are highest in high-poverty neighborhoods. The greatest individual and community-level factor associated with asthma disparities is varying exposure to triggers in the home, most notably cockroaches and mice. Asthma health care costs are significant, and prevention efforts to reduce triggers could result in improved outcomes and significant cost savings. Unlike traditional pest control, which relies on pesticides, IPM eliminates pests and prevents re-infestation by addressing housing conditions conducive to pests and with safe, targeted use of pesticides. This project targets low-income children with the potential to significantly improve their health and well-being. A total of 400 families - 400+ children which includes screened and recruited siblings - will be recruited on to the study. The study is designed to evaluate an inexpensive and scalable environmental intervention for asthma that can be replicated in other New York City neighborhoods and incorporated into any urban healthcare setting in New York State and nationwide.
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Change from baseline in counts of urgent care (unscheduled ambulatory) visits at 6 months
Timeframe: Baseline to 6-months
Change from baseline in costs of urgent care (unscheduled ambulatory) visits at 6 months
Timeframe: Baseline to 6-Months
Change from 6-months in counts of urgent care (unscheduled ambulatory) visits at 12 months
Timeframe: 6 months and 12 months
Change from 6-months in costs of urgent care (unscheduled ambulatory) visits at 12 months
Timeframe: 6 months and 12 months
Change from baseline in counts of urgent care (unscheduled ambulatory) visits at 12 months
Timeframe: Baseline and 12 months
Change from baseline in costs urgent care (unscheduled ambulatory) visits at 12 months
Timeframe: Baseline and 12 months
Change from baseline in counts of Emergency Department visits at 6 months
Timeframe: Baseline to 6 months
Change from baseline in costs of Emergency Department visits at 6 months
Timeframe: Baseline to 6 months
Change from 6-months in counts of Emergency Department visits at 12 months
Timeframe: 6 month to 12 month
Change from 6-months in costs of Emergency Department visits at 12 months
Timeframe: 6 month to 12 month
Change from baseline in counts of Emergency Department visits at 12 months
Timeframe: Baseline to 12 months
Change from baseline in costs of Emergency Department visits at 12 months
Timeframe: Baseline to 12 months
Change from baseline in counts of hospitalizations at 6 months
Timeframe: Baseline to 6 months
Change from baseline in costs of hospitalizations at 6 months
Timeframe: Baseline to 6 months
Change from 6 months in counts of hospitalizations at 12 months
Timeframe: 6 months to 12 months
Change from 6 months in costs of hospitalizations at 12 months
Timeframe: 6 months to 12 months
Change from baseline in counts of hospitalizations at 12 months
Timeframe: Baseline to 12 months
Change from baseline in costs of hospitalizations at 12 months
Timeframe: Baseline to 12 months