INDOOR AIR QUALITY
Research, Education and Advocacy
CARE-Air Quality is designed to build capacity (i.e., training and education) and provide service coordination to promote healthy indoor environments in homes, schools and child care settings. We educated school nurses and staff, home health care providers, health care professionals, student nurses and early childhood educators to train, do outreach and demonstrate projects that seek to reduce exposure to indoor air contaminants and asthma triggers (e.g., dust, mold, second hand smoke and smoke from wood burning stoves).
Asthma has been identified as one of the top five priority concerns from community members who participated in the SLVEC valley-wide CARE Level 1 outreach for prioritizing environmental health risks.
The Four Pillar Program
Workforce Training on Indoor Air Quality
This segment of the IAQ program trains Early Childhood Educators (ECE’s) to attain the necessary knowledge and skill to incorporate an initial assessment of home environments. If issues are identified, the program provides the educational tools, support materials and appropriate follow up referrals. This indoor air quality knowledge base includes identification of asthma triggers and avoiding exposure as well as delivering outreach educational tools to directors, teachers and early Headstart Family Partnership managers.
Partners in this training: SLVEC, Early Childcare Council, National Jewish Health, Paula Hendricks, Certified Health Education Specialists (CHES), Head Start
Materials Provided: Power point on Asthma, Allergies and Indoor Air Quality, Green Cleaning Solutions(SLVEC), 2nd hand smoke and the health of your family (EPA), Why Quit tobacco (SLV Health),Tips to protect children from environmental risks, (EPA), Make Your House a health home (EPA), List of programs for home repair in SLV (ERC), Take Action to improve air quality,(EPA) Radon EPA, A Healthy Home Checklist (DHSS), Asthma home check list, (EPA)
Sept: 2013: Indoor Air Quality Training for Early Childcare Providers
Presenter: Lisa Cicutto, RN PhD.
There were 24 childcare providers that offer care for 196 families trained on the importance of IAQ, especially for children with asthma and allergies. In all, a total of 196 people were reached: 72 families from Early Childcare (25-Babies plus 47 1-3 year olds) and 124 families from Head Start.
In this program, the importance of ventilation, asthma triggers and allergens vs. irritants is presented. Prevention of triggers, safe cleaning agents, the connection between asthma, allergies, and ear infections, dust mite information, and effects of second- hand smoke were also covered in this program.
Materials used in this program: Power point on Asthma, Allergies and Indoor Air Quality, Green Cleaning Solutions(SLVEC), 2nd hand smoke and the health of your family (EPA), Why Quit tobacco (SLV Health),Tips to protect children from environmental risks, (EPA), Make Your House a health home (EPA), List of programs for home repair in SLV (ERC), Take Action to improve air quality,(EPA) Radon EPA, A Healthy Home Checklist (DHSS), Asthma home check list, (EPA)
June 2013: Tobacco Cessation Workshop for public health nurses and various health agencies
Presenter: Fred Wamboldt, MD, Colorado Director for Health Promotion and Professor of Medicine, National Jewish Health.
This workshop was an opportunity for Public Health staff to receive training and latest techniques for helping patients to quit tobacco. This also brought in other healthcare providers from clinics and hospitals, mental health and school nurses. Twenty providers attended the training representing 13 agencies.
During the program it was revealed that many public health departments have lost much of their funding for smoking cessation. Quitline only accepts insured or Medicaid/Medicare. Public Health is working with SLV Health to promote cessation efforts.
School-Based Asthma Management
This segment of the Indoor Air Quality Program trains student nurses in a four- hour workshop on applying the OAS (Open Airways in Schools) method that is designed to work in school settings.
School nurses and local nursing students deliver an enhanced version of the Open Airways in Schools (OAS) to reach school-aged children. This program was developed by the American Lung Association to educate and empower children through a fun and interactive approach to asthma self-management. It teaches children with asthma ages 5-12 how to detect the warning signs of asthma, avoid their triggers and make decisions about their health.
School nurses from the 14 school districts in the SLV and National Jewish Health worked together to improve asthma management and education in schools. Ten school nurses received formal training in 2013 to become Open Airways for Schools instructors with the program being fully implemented in Alamosa and the Del Norte Public School systems 1st-6th grade. Open Airways in Schools consists of six to eight, 40-60 minute sessions. For this project, one additional interactive lesson will be added that focuses solely on indoor air quality and triggers. The triggers discussed include exercise induced asthma and cold air.
Adams State University (ASU) is supportive of establishing student nurse placements in schools throughout the Valley to assist school nurses with the implementation of Open Airways for Schools. Six to eight school nurses will work with 5-10 students per session of varying age groups, so the ability to divide the groups along more developmentally appropriate levels would enhance the interactive, hands on learning sessions. The use of student nurses would accommodate this approach and greatly enhance the program. In turn, the student nurses will receive opportunities to provide direct patient education and disease management programs, perform child assessments, and participate in evaluation of student learning and program evaluation. Student nurses are required to have pediatric placements during their training programs to be eligible to write the state nursing boards. These school nurse placements will fulfill the student nurse requirements of teaching health and disease management education, interview skills, assessment skills and evaluative skills. The OAS Program can also enhance their existing respiratory curriculum. Most of the school districts within the SLV already have pre-existing agreements in place that will permit student nurses to go into the schools to work with students under the guidance of the school nurse.
SLVEC, National Jewish Health, Paula Hendricks - CHES, Adams State University Nursing Program, School Nurses from Alamosa, Moffat, Sangre de Cristo, Center, DelNorte, Mountain Valley School, Creede, and the American Lung Association (Open Airways for Schools Program from ALA)
From January 2013 to February 2015, 55 student nurses were trained in the OAS program which ultimately reached 147 students versed in asthma control training.
This IAQ segment established partnerships between school nurses and the Adams State University nursing program, a goal which will continue to effect asthma awareness and treatment well into the future.
Power point by Dr. Cicutto, 2nd hand smoke and the health of your family (EPA),Quitline information sheet, (Colorado Quitline), Green Cleaning Solutions
(SLVEC), Indoor Air Quality Background (Tools for Schools)
During home visits, a home environment assessment is completed; if potential unhealthy exposures are identified, an action plan is developed to improve home environments. Follow-up visits occur to ensure that action plans are implemented. The program also develops support materials for home health care providers such as a guide and report sheet specific to the San Luis Valley and a guide using existing community preventative services. Radon gas education and advocating the importance, feasibility and value of radon testing is also an important component to this segment. Avenues to reduce risk for those who lack funds to test for radon are also provided in this tool kit.
The home assessment strategy created several tools to evaluate interior environments such as the SLV Home Indoor Air Quality Assessment Tool, Action Plan Template and Care Provider Training.
Materials Provided: Training power point (P. Hendricks, CHES), Indoor Air Action Plan, In Home Air Quality Assessment Tool, (SLVEC), Green Cleaning Solutions(SLVEC), 2nd hand smoke and the health of your family (EPA), Why Quit tobacco (SLV Health),Tips to protect children from environmental risks, (EPA), Make Your House a health home (EPA), List of programs for home repair in SLV (ERC), Take Action to improve air quality,(EPA) Radon EPA, A Healthy Home Checklist (DHSS), Your Water: Your Health (SLVEC, Sangre De Cristo Labs, CSU Extension Service)
Costilla County benefitted from this program. In 2014, outreach health care providers evaluated home environments housing 189 people and offered corrective strategies for home hazards such as carpeting and wood-burning stoves.
Elsewhere in the San Luis Valley, La Llave staff were trained in home assessments. By 2015, 35 households in 5 counties completed the home survey effecting 133 people. La Llave is a non-profit based in Alamosa designed to help families rear healthy children and prepare them for school.
Capacity Building through Community Partnerships and Community Education
An essential part of the Indoor Air Quality Program is developing partnerships within the San Luis Valley. We thank our major collaborator, Denver- based National Jewish Health.
The guidance of National Jewish's Dr. Lisa Cicutto helped SLVEC to connect with Adams State University Nursing Program, SLV Public Schools and countywide Public Health organizations.
Over the life of this program connections and Indoor Air Quality programs were initiated with Adams State University, the school systems in the SLV, the Public Health systems of Saguache, Alamosa and Rio Grande counties, Rocky Mountain Prevention Research Center, Adelante, and LaLlave.
SLVEC also coordinated a visit and discussion with the National Brownfields Coordinator, Center for Disease Control, and the Agency for Toxic Substances and Disease Registry. This attracted attendance from 20 SLV agencies. Illegal dumping and solid waste disposal issues were addressed.
These discussions led to eventual actions that are now being tackled by the SLVEC Solid Waste Management Program.
IAQ materials and hands-on discussions were also provided to the community by presenting booths at the many local health fairs. These fairs offered opportunities for the distribution of dust masks and bandanas, dissemination of green cleaning solutions, home evaluation assessments and individual consultations.
Indoor Air Quality Resource Documents
Information and Background Materials
Indoor Air Quality Program Summary 2013-2015
Indoor Air Quality Program Summary Chart 2013-2015
Indoor Air Quality-Environmental Protection Agency
Radon Gas Health Risks
San Luis Valley Air Toxics Analysis 2012
Asthma Awareness/Assistance Program for Student Nurses
Green cleaning solutions for your home
Teen Smoking Concerns/ Tobacco Cessation
Other Materials, Hand Outs and Presentations
Guideline for Smoking Cessation and Second Hand Smoke
Second Hand Smoke Brochure
Why Quit Smoking? Brochure
Testing and Surveys