2021 Seed Grant Award Problem Statements 

Health and Wellbeing

Problem #1: Building a solution that performs environmental assessments to identify asthma triggers in the home by virtually walking through an individual’s home.

Country/Region of execution: Bronx, NY, USA
Collaborating Organization: Bronx Community Health Network
Bronx Community Health Network (BCHN) is a not-for-profit organization and Federally Funded Health Center that sponsors 21 community and school-based health centers in the Bronx. BCHN aims to improve the health of people and families in the Bronx, provide access to affordable, quality health care, promote disease prevention, and obtain financial and other resources to bring services to those who need it most.
Problem Statement Description: Asthma disproportionately affects those in low-income neighborhoods and is no exception in the Bronx, where 1 in 4 children suffer from asthma. Asthma not only requires appropriate clinical management, but also must accompany strategies for addressing the social determinants. Asthma is commonly attributed to outdoor as well as indoor environmental conditions, such as housing quality and exposure to pests. Home-based intervention is a critical component of asthma management, as asthma education and control of environmental triggers often require more time and resources than can be achieved in the clinical setting.  Individuals with uncontrolled asthma are often referred to home-based services, but we have learned that home-based visits are a challenge, as, despite significant engagement activities, only 38% of individuals accept and complete a home visit. There are many factors that come into play, but a core barrier is a basic resistance to allowing a stranger into one’s home. Families have expressed concerns of having an undocumented relative, or unsafe conditions (i.e., overcrowding, etc.) reported to the authorities. Moreover, families often feel judged for their poor living conditions (i.e., pests, rodents, etc.). Having a virtual home-based assessment is an innovative, less invasive, and cost-effective way of engaging with individuals and families to support asthma management. This would provide an additional option for providing home-based services and would break the barriers that currently prevent successful in-home assessments. This application would provide access to services that best fit individual needs and personal circumstances and combat uncontrolled asthma in the Bronx. The application would support in conducting environmental assessments to identify asthma triggers by virtually walking through the home with the patient/family. The application will also support representatives providing the home-based visit in connecting with individuals to review their existing Asthma Action Plans, review medication, provide education, and make external referrals.