Just Keep Breathing: The At-Home Asthma Program for Children

Asthma is the most common chronic disease of childhood. According to the Centers for Disease Control and Prevention, approximately 6.2 million children in the U.S. between birth and 18 years old are living with asthma. And although there isn’t a cure, children who have it can thrive with proper treatment and a healthy environment. The thing is, families may have asthma attack triggers right in their home without knowing it.

Troublesome triggers

A child living with asthma might not know they have it until they come into contact with a “trigger” — something in their environment that causes the airways in their lungs to become inflamed or swollen, allowing less room for air to flow in and out.

For many families, those initial asthma attacks can be scary, but seeing a medical provider for diagnosis, treatment, education and routine follow-up is enough to help them successfully manage the condition long-term. But for some families, it isn’t. Even after a visit to an asthma specialist at Children’s Colorado, some kids still struggle to control their severe asthma. When that happens, the Just Keep Breathing Program springs into action.

Asthma treatment at home

Funded by the Cancer, Cardiovascular and Chronic Pulmonary Disease Grants Program, the Just Keep Breathing Program is free for families in the Children’s Colorado Asthma Program who live in the Denver Metro area.

Among a few other parameters, families qualify if they’ve had a child who’s experienced two emergency department visits or has had a hospital stay within the past year due to asthma. These are the best predictors of whether a child will have another severe asthma attack over the next year and can indicate a need for extra support.

“It’s completely up to the family whether they want to participate,” says Kate Johnston, MPH, who manages the Just Keep Breathing Program. “If they agree, we provide three to five home visits, each about a month apart.”

These visits include a home assessment to help families check areas like vents and cabinets that can reveal asthma triggers they might not even know are there. The visits are led by experienced community health navigators who understand how to screen for health barriers in the home. Once they identify potential problems, the navigators help families make a plan to address them. Navigators also teach families how to fit asthma care, like taking medications, into their daily lives.

If a family doesn’t qualify for the Just Keep Breathing Program, AsthmaCOMP may be an alternative. In certain regional school districts, it’s a free program for students ages 5 to 14 with uncontrolled asthma, and it provides students with quick relief medication and an asthma care plan while at school. Caregivers can call 720-777-5800 for more information.

Making asthma in children much more manageable

Since the first home visit in 2016, Johnston says that 67 Children’s Colorado asthma patients have completed the Just Keep Breathing Program and another 29 are actively participating. And she says a lot of the program’s success is due to the community health navigators.

“They build rapport with these families so quickly and so strongly, and that’s the most important part of this program,” says Johnston. “It’s why it works. If the family doesn’t want a navigator to go into a certain room of the home, then they don’t go in there.”

“Going into a family’s home gives you a whole new perspective of their life — a view providers don’t get in a clinical setting,” says Children’s Colorado community health navigator Elsy David. “You have a better sense of what challenges they face. When we understand the full picture, that’s when we can truly support them.”

Whether a family participates in the Just Keep Breathing Program or AsthmaCOMP, the initiatives provide new tips for caregivers and help raise the knowledge and confidence level of the child. Both make asthma treatment at home much more manageable for everyone and reduces the risk for acute asthma attacks.

Top seven asthma triggers in the home

If your child has asthma, avoid these common triggers:

• Smoking, vaping or secondhand exposure
• Pet dander
• Dust
• Mold
• Combustion (such as a wood-burning fireplace)
• Pests (such as mice, rats and cockroaches)
• Chemicals or products with strong smells

Take action against asthma triggers

Here are a few easy ways to avoid top asthma attack triggers in the home:

• Do not smoke or vape inside the house or car. If you are ready to quit smoking, talk to your healthcare provider or call the QuitLine at 1-800-784-8669.
• Dust, vacuum and sweep floors regularly, and keep pets out of the bedrooms of anyone with allergies.
• Get rid of standing water and fix water leaks as soon as possible to avoid mold.
• All cooktop stoves should be well-ventilated, and furnace filters should be changed regularly.
• Fix any holes or gaps in walls, flooring, and pipes that could allow pests to enter the home.
• Avoid scented home products as well as cleaning supplies that include ammonia or bleach.
• Place doormats in front of doors that lead outside.
• Have everyone leave their shoes at the door.