Community Health Workers' Role In Supporting Pediatric Asthma Management: A Review

Objective: Community health workers (CHWs) have been effective in improving health outcomes in vulnerable communities by providing health education and management services. We review CHW-led asthma education and management interventions for children and their families. Next, we describe the selection and training of CHWs in pediatric asthma management in the Rhode Island Asthma Integrated Response Program (RI-AIR). Method: We queried the MEDLine, Cochrane, PubMed, and EMBASE databases with keywords (community health worker, asthma, health worker, lay worker, pediatric, child, and childhood) from inception until September 2019. Criteria for study inclusion included the following: published in English, conducted in the United States, approved with an ethics notification, published in a peer-reviewed journal, and involved CHWs as the interventionists. The initial search identified 216 articles. Fifteen studies met criteria for inclusion. Results: CHWs provide asthma management and education services, including home environmental trigger assessments, strategies to reduce environmental trigger exposure, resource linkage, and community referrals. We describe RI-AIR and its CHW-led asthma education and management interventions. Conclusions: CHWs are effective and vital supports for positive asthma outcomes. More research is needed to guide models of intervention using CHWs, specifically addressing integration in interdisciplinary teams, training, and reimbursement for CHW services.