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Healthy Homes: Building Community Partnerships for Lead Mitigation Education and Parent Empowerment in Michigan

Thu, March 21, 12:30 to 2:00pm, Baltimore Convention Center, Floor: Level 3, Room 323

Integrative Statement

Housing shortages in Kent County (KC), MI, which includes the city of Grand Rapids, have resulted in low-income families with young children unable to obtain stable, sufficient housing. Developmental scientists have recently highlighted housing quality and related environmental exposures during early life as important negative influences on children’s social, cognitive, and health outcomes (Coley, 2013; Trentacosta, 2016).

In 2014, a KC Community Health Survey indicated that almost 50% of respondents lived in homes built before 1978—the year lead-based paint was banned in the US. Over 15% of respondents reported peeling paint in their homes, and almost 60% of children under 6 years-old with elevated blood lead levels (BLL > 5 ug/dL) lived in pre-1978 housing. Elevated BLL rates were greater in KC (6.0%) than in the state of Michigan (5.0%), and more than double national rates (2.8%; Chmelar, 2014).

Homes that pose an elevated health risk with respect to lead and other important environmental hazards (e.g., mold, pests) may not receive the level of inspection or mitigation necessary to address the potential impact to children’s health. Given that early childhood is a sensitive period in development in which lead exposure has implications for physical growth as well as cognitive skills and social-behavioral functioning, it is vital to identify and address such hazards for under-resourced families with young children.

Since 2013, the Community Outreach and Translation Core of the Children’s Environmental Health and Disease Prevention Center at the University of Michigan has partnered with community-based agencies in KC—such as The Healthy Homes Coalition of West Michigan (HHC) and the KC Health Department (KCHD)— to address child environmental health. HHC, through preventive in-home visits and education, seeks to improve children’s health and wellbeing by eliminating harmful housing conditions. Responding to community concerns, the KCHD convened a Task Force seeking to provide recommendations to stakeholders on lead mitigation. In the current collaborative project, these three partners therefore sought to: 1) design a curriculum using developmentally-focused, locally relevant materials to promote knowledge, empowerment, and skills for parents of preschool-aged children to take action on household lead mitigation; 2) develop a protocol and train Peer Educators to deliver the curriculum to parents in their communities; and 3) evaluate these efforts.

Briefly, the curriculum combines didactic and interactive activities to achieve the following learning outcomes:

1) Knowledge of the effects of lead exposure on child development and exposure routes in the home (e.g., dust, paint, soil) and an understanding of developmentally-specific concerns (e.g., fingers in mouth);
2) Self-efficacy/empowerment to seek BLL testing and to reduce the mechanisms of transmission at home (e.g., safe cleaning practices; knowing where lead exists);
3) Skills to reduce and mitigate home exposure (e.g., washing hands after outside play; removing shoes).

This presentation will describe the formation and evolution of our partnerships and partnership principles, curriculum examples, peer educator recruitment and training processes, and evaluation tools. Future goals of the collaboration include developing training protocols and educational materials for use with other child health providers and analysis of evaluation data.

Authors