Putting On AIRS (POA) program is a Connecticut asthma home visiting program that provides intensive asthma management, education, and environmental support for people with asthma that is poorly controlled.

From 2008-2014, over 1,200 CT residents have participated in the original POA program. Over time, promotional activities, regional outreach and education to health providers have led to an increase in clients being referred for program services. Furthermore, a greater participation of local health departments has facilitated the delivery and expansion of the statewide asthma program.

Between 62.1% and 68.0% of participants completed the POA program (home visit and follow-up calls) during the 2008-2013 period. A sharp decline in 2014 to 50.3% participants is likely attributed to a change in the POA protocol, where a maximum of three calls were made to set-up follow-up calls at three months and six months. This decision was made to expand the home-based services to a greater number of residents.

In 2016, following an evidence-based model, the POA service delivery was modified to consist of an environmental evaluation, asthma assessment, education and management at three home-visits and a 6-month phone call follow-up. During 2016-2019, a total of 656 individuals participated in at least some portion of the three-visit program. During that time, the percent of POA clients completing at least 60% of the program, or at least two home visits, ranged from 72.9% to 82.2%

At the outset of the COVID pandemic in early 2020, home visits ceased and the program gradually transitioned from an in-person to a virtual service delivery approach. Services delivered during 2020-2022 therefore represent mostly online exchanges. The challenges of conducting program visits online and well as other pandemic-related hardships drove down client participation during those years, with 162 clients participating during 2020-2022. During that time, the percent of POA clients completing at least 60% of the program, or at least two home visits, ranged from 66.0% to 72.9%.

The POA program addresses poorly-managed asthma; so, the potential for intervention delivery is highest in towns with the highest rates and numbers of asthma emergency department visits and hospitalizations. In Connecticut, children, females, Hispanics, non-Hispanic Blacks and residents of the state’s five largest cities (Bridgeport, Hartford, New Haven, Waterbury, and Stamford) are disproportionately affected by asthma. During the period 2016-2022, POA services were most frequently delivered to children, males, non-Hispanics, and residents of New Haven and Fairfield counties. Analysis of the sociodemographic characteristics of clients who received services between September 2016 and December 2022 demonstrated that across the asthma planning regions in which the intervention is provided, which have decreased from six to three during that timeframe, clients were most often children ( 83.2%), male (50.8%), non-Hispanic (50.5%), and Whites ( 62.8%) (Source: Putting on Putting on AIRS, Evaluation of a home-based asthma intervention in Connecticut, February 2023).

Note: These data are current as of February 2023. New data are expected by spring of 2024.

Data from 2015 are unavailable due to a change in POA service delivery, and data from 2016 are based on only 4 months of data from 9/1/2016 to 12/31/2016. 

Hospitals, local public health departments, health care providers, community health centers, school-based health centers, school nurses

Implementation of the National Asthma Education and Prevention Program recommendations:

1. that all patients be educated about asthma self-management skills, self-monitoring, use of asthma action plan
2. all patients should reduce exposure, as much as possible, to allergens to which they are sensitized and exposed to
3. asthma education should be delivered in the homes of caregivers of children with asthma (NAEPP EPR-3, 2007, p.109; 115; 169)
4. all clinicians must provide to all patients who have asthma a written asthma action plan that includes instructions for (1) daily management and (2)recognizing and handling worsening asthma, including adjustment of dose of medications (NAEPP EPR-3,2007, p.115)

The Community Preventive Services Task Force recommends the use of home-based, multi-trigger, multicomponent intervention with an environmental focus for children and adolescents (The community Guide, 2013).

Work with local health departments to:

• Provide the home-based asthma and environmental program (HBAEP) to referred asthma residents
• Expand the delivery of the HBAEP and increase the number of participating towns
• Promote to health providers, community health organizations and school nurses, the referral of residents with poorly controlled asthma to the HBAEP
• Provide culturally-sensitive HBAEP