Compared to many outdoor environmental exposures, it is difficult to improve the home environment through state and federal actions. Fortunately, in many cases it is relatively simple and inexpensive for individuals to prevent exposure to home health hazards. Other times, addressing home hazards also requires collaboration and cooperation between housing providers, government agencies, community groups, property owners, and tenants. Innovative strategies to address home environmental health hazards and foster these complex relationships can significantly improve public health in a community, and can take on many forms.
In 2005, community engagement staff from the University of Rochester Environmental Health Sciences Center (UR) partnered with two community organizations – the Southwest Area Neighborhood Association (SWAN) and the Rochester Fatherhood Resource Initiative (RFRI) – to develop an action-based community education project aimed to teach residents, medical professionals, community groups, housing providers and others how to reduce home-based environmental exposures. These Healthy Home (HH) partners were initially motivated to reduce lead poisoning in Rochester, but expanded their scope to integrate treatment of lead hazards with other home hazards through a multifaceted approach.
An innovative approach to home environmental health education
Rochester’s Healthy Home was located in a residential neighborhood. Housing the project in a rental unit helped visitors visualize the home setting, and increased access for local residents.
The partners considered many strategic options for community education, and in 2006 created Rochester’s Healthy Home (RHH). The facility, a home-based “museum” of environmental health hazards, was housed in a residential (rental) unit and remained open through December 2009. The partners chose to create RHH instead of conducting home visits due to limitations related to cost, effectiveness and sustainability. While home visits that demonstrate hazards and solutions in a client’s home can have a positive effect on health and personal behaviors, the partners agreed that a home visit-based program would be too costly, time consuming, and limited in long-term impacts.
A model for all
Rochester’s Healthy Home was for not only community residents, but also professionals from various backgrounds who might be able to integrate healthy homes education with their work. During its four years in operation, over 3500 residents, property owners, community groups, students, health care professionals, elected and appointed government officials, housing groups, and human services agencies, among others, toured the Home and learned how home environmental health influences overall health and well‐being.
The Home was staffed by a full time program manager, supported by the core RHH partners and an advisory council (HHAC) to guide programs, apply for funding, and plan new exhibits. Comprising over thirty members from local organizations, the HHAC also contributed to the development of new partnerships and home health-based programs.
Visual and hands-on educational displays taught visitors how to take action
Visitors learn how to set and bait a mouse trap.
Healthy Home partners aimed to educate, motivate, and support visitors in taking action to overcome some of the many barriers to achieving healthier home environments. To this end, tours focused on demonstrating simple, low‐cost strategies, and referred visitors to local resources that could help them with more complicated solutions. The Healthy Home presented educational displays in a realistic, home-like setting. For example, an “asthma-safe bedroom” included a bed with dust mite covers, a “safe housekeeping” demonstration station (including non-toxic cleaners), and plastic toy storage tubs to reduce dust accumulation. The kitchen included “chemical look-alikes” (hazardous chemicals whose packaging resembles food products) and tools for integrated pest management (such as bait traps), since pest problems are often found in kitchens.
A tour guide talks about using vent fans to reduce moisture and mold in the home.
These displays were based on input from local and national organizations focused on each individual hazard, and included information on local resources that could provide additional help. The Healthy Home initially focused on asthma triggers, lead poisoning, indoor air quality, and toxic chemicals. Over time, visitors and partners suggested additional topics that were incorporated into displays and programming, including safe food preparation, injury prevention, bed bugs, lice, and lead safe gardening.
Project evaluation
The partners tracked effectiveness of the RHH model through evaluation forms and action plans completed by visitors after tours. The evaluations offered immediate feedback for staff and helped visitors consider hazards they might face in their own homes, while the action plans acted as a follow-up mechanism to track visitors’ behavioral changes over time as a result of their RHH tour. RHH staff contacted a sample of visitors 6-18 months after their visit, and found that more than three quarters had completed actions to reduce their exposure to home environmental health hazards based on information learned at RHH. In many cases, these calls also allowed staff to provide additional information to help visitors complete their planned actions.
Continuing education after closing
Despite its enormous success in educating broad audiences about environmental health hazards, the Healthy Home was resource intensive, requiring committed personnel and substantial financial resources. Recognizing from the beginning that the resources required for maintaining the Healthy Home made it an unsustainable long‐term project, the partners planned Rochester’s Healthy Home for a time‐limited facility from the outset. Primary funding for the Healthy Home was provided through a three-year U.S. EPA Environmental Justice grant; special outreach programs were supplemented by various local, state and federal funding sources. The RHH partners were careful to document the project development process to assist other communities interested in developing similar initiatives. When the Healthy Home closed its doors in 2009, project partners documented their experiences and posted information online as a resource for healthy homes education in the Rochester area. In addition, the Rochester Healthy Homes Partnership (formerly the HHAC) remains active through monthly meetings. This networking group has fostered several other programs that continue education for local groups, including refugees, migrant workers, child care providers, housing professionals and community residents.
Authors :Valerie Garrison Program Manager University of Rochester Medical Center Environmental Health Sciences Center Community Outreach and Engagement Core Katrina Korfmacher, Ph.D. Associate Professor of Environmental Medicine Director, Community Outreach and Engagement Core Environmental Health Sciences Center