OBJECTIVES: To assess the impact of virtual Environmental Improvements for Children with Asthma (EICA) on asthma symptom burden and control from baseline to 12-month post-intervention. EICA is an American Lung Association assessment and modification program designed to reduce asthma symptom burden in the home setting by reducing exposure to environmental asthma triggers. Pre-pandemic EICA was an in-home visit program; COVID-19 required adoption of virtual visits.

METHODS: Data on environmental asthma triggers such as biological (mold, cockroaches, rodents, pets), chemical air (dust, tobacco smoke, cooking smoke, cleaning agents, air fresheners, candles, carpeting), and mechanical sources (child sleeping on carpet, heating sources, water leaks, broken windows, holes in the walls), asthma control test (ACT) scores, and symptom burden using Child Asthma Short Form (CASF) was collected at baseline, 3- and 12-months post-intervention from 20 households between February 2020 and March 2021. T-test compared differences at baseline and 12 months post-intervention for continuous scores; Chi-square was used to test for proportional differences in severity of CASF domains. P-value ≤0.05 indicated statistical significance. Analysis was completed using RStudio.

RESULTS: Dust (85.71% of households), carpet (71.43%), air fresheners (66.67%), and cleaning chemicals (57.14%) were major sources of asthma triggers. There was statistically significant improvement in ACT scores (mean difference=4.95; p<0.005), and CASF daytime symptoms (mean difference=18.12; p<0.005), nighttime symptoms (mean difference=23.12; p<0.005) and functional limitations (mean difference=17.19; p<0.005). Based on CASF scores, 25% of children had severe daytime symptoms at baseline but at 12 months only 5% (X²=4.38; p=0.11); 35% of children had severe nighttime symptoms at baseline, but at 12 months only 5% (X²=6.5; p=0.03); 10% of the children had severe functional limitations at baseline but at 12 months, no children had severe functional limitations (X²=3.69; p=0.16).

CONCLUSIONS: A virtual EICA program led to significant improvements in asthma-related symptom burden and asthma control.