Abstract Rationale Community health worker (CHW)-led asthma home visit programs are effective in improving asthma outcomes and reducing health disparities in children when conducted in person. The use of both phone-based and videoconferencing approaches have gained popularity, but it is unclear whether these can adequately uncover home environmental concerns, or whether they are acceptable or feasible for clients and program staff. The King County Asthma Program recently piloted a novel targeted video home environmental assessment. This study evaluates the acceptability and feasibility of this approach for clients and CHWs. Methods New King County Asthma Program clients were offered the choice of having a home environmental assessment conducted by video (the new “Video Track”) or telephone (the “Phone Track”). Adult parents of children with asthma aged 5-17 years who had recently completed either track were invited to participate in the study. Participants and CHWs completed surveys assessing their perspectives on feasibility and acceptability of their home assessment based on the Theoretical Framework of Acceptability. Asthma Program data regarding environmental concerns identified were also obtained. Data were analyzed descriptively. Results Five clients participated in the Phone Track and 6 in the Video Track. All clients rated their home assessment highly regarding perceived effectiveness, intervention coherence, and self-efficacy, and concerns regarding burden, privacy, and opportunity cost were low. More clients in the Video Track viewed their experience positively versus the Phone Track (100% vs 60%). All Video Track participants felt that video made it easier to communicate their concerns, while 20% in the Phone Track believed adding video would have helped. Four out of 6 participants in the Video Track had no technical difficulties, while the remaining 2 experienced multiple issues. CHWs felt overwhelmingly positively about their experience in both tracks, and reported that adding video would have made the home assessment easier for 2 out of 5 clients on the Phone Track. Other results mirrored the experience of clients. Conclusions Overall acceptability of both the Phone and Video Tracks were high for both clients and CHWs. Clients were generally satisfied with their choice of track, while CHWs identified some instances where adding video would have helped clients in the Phone Track. Video home assessments are promising for evaluation of environmental home concerns for children with asthma, but accessibility for disadvantaged groups must be considered. Larger-scale randomized studies are needed to determine effectiveness in comparison to in-person or phone-based programs. This abstract is funded by: National Institutes of Health
Crocker et al. (2026) studied this question.