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CLPPP Transitions CourseExpanding from a Childhood Lead Poisoning Prevention Program to a

Healthy Homes Program

“The connection between health and the dwelling of the population is one of the most important that exists”. [1]

Florence Nightingale

Citado en Lowry, S. BMJ, 1991, 303, 838-840

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Health problems related to housing conditions

Asthma Allergies Brain damage Behavior & learning problems Lung cancer Injuries Poisonings

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Context for a Healthy Homes Program

Part of Goal 2 of Healthy People 2020 (a national health agenda)

Part of Healthy People 2020 Environmental Health Objectives

Surgeon General’s Call to Action to Promote Healthy Homes

Presidential Executive Order 12898 for Environmental Justice

CDC’s Healthy Homes Initiative

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Conducting a Needs AssessmentFirst step in developing a Healthy Homes Program. The needs assessment should address:

— Community analysis

— Training and education

— Policy

— Program experience

— Partnerships

— Program evaluation

— Surveillance

Strategic Plan

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Community Analysis

What are the community demographics?

What are the health issues in the community?

What are the housing needs in the community?

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Training and Education

Healthy Homes Training Center courses: Essentials for Healthy Homes Practitioners

Launching a Healthy Homes Initiative

Pediatric Environmental Home Assessment (on-line training)

Healthy Homes for Community Health Workers

Integrated Pest Management in Multi-family Housing

Code Inspection for Healthy Homes

Go to www.healthyhomestraining.org

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Training and Education (continued)

CDC Healthy Homes/Lead Poisoning Prevention Training Center – 4 tracks:

Program Management

Data Management and Surveillance

Case Management

Primary Prevention

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Policy

Identify strengths and gaps in:

State and local laws

Regulations

Ordinances

Program enforcement policies

Identify local housing codes and who enforces them

Develop an approach to address gaps

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Program ExperienceAssess organizational capacity:

• Agency resources• Past performance• Infrastructure• Management• Knowledge/skills of staff pertaining to Healthy

Homes

Don’t forget the Healthy Homes Specialist Credential

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PartnershipsIdentify partners who can help address healthy homes issues:

• Housing programs• Public health programs• Faith-based and community organizations• Environmental justice and academic centers• Local, state and federal governments• Youth centers• Universities• Fire departments• Advocacy groups• Others

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Referral ProcessDevelop plan to identify, address and resolve housing issues. Sample flowchart to describe referral process:

Home visiting Pgm./HH Inspectors

ReassessIssue

Identify issue

Program addresses

Partner addresses

No Issue Resolved?

Yes

Document in HH database

Permanent

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Program EvaluationEvaluation should answer two questions:

1. Are program activities being implemented and functioning as planned? (process evaluation)

2. Are program activities having the intended effect? (outcome/impact evaluation)

Suggested approaches to evaluation:— Four standards of utility, feasibility, propriety and

accuracy— Using SMART objectives (specific, measurable,

achievable, relevant and time bound)— Logic model

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Surveillance

May need to modify existing surveillance systems or develop new ones to include healthy homes issues.

CDC has developed a new web-based Healthy Housing and Lead Poisoning Surveillance System (HHLPSS) that is available

Contact your CDC project officer for more information on how to obtain or transition to HHLPSS

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Strategic Plan

Should address four primary questions:Who is the target audience for the intervention?What are the HH constraints of the target audience for the intervention?How will the identified HH needs/constraints be addressed?What are the expected outcomes?

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Best Practices- Programs should focus on interventions with proven efficacy. - Here is a sample of Interventions where there is “sufficient evidence” to indicate efficacy in improving health:

Multi-faceted tailored asthma interventions Integrated Pest Management (pest/allergen reduction) Moisture intrusion elimination Radon air mitigation through active sub slab

depressurization Smoking bans

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Best Practices (continued)- Programs should focus on interventions with proven efficacy. - Here is a sample of Interventions where there is “sufficient evidence” to indicate efficacy in improving health:

Smoke Detectors Lead hazard control Installation of working smoking alarms Pre-set safe temperature hot water heaters Housing Choice rental voucher program