Last Updated: February 2023

Updated by The Vermont Asthma Program

The current data reflects data for combined survey years 2015-2017 after the question was reinstated into the ACBS survey.  Among youth, 27% with current asthma have been advised by their health professional to change things in their environment at home, school, or work to improve their asthma. 

NOTE: The data for this measure was available through 2010, then suspended from the survey.  In recent years, there has been a decreasing number of respondents for the Child Asthma Callback Survey; this is a problem that several other states are also facing and accounts for why the question was removed temporarily in 2010.  The measure has been reinstated after the decision to combine 3 years of data from the Child Asthma Call-Back Survey.

Following the release of the National Guidelines on the Diagnosis and Management of Asthma (EPR-3) in 2007, the data reached an all time high of 49% just below the target of 50% in 2008.  Unfortunately, the trend reversed direction with a steep trend downward over the next two years, and has remained relatively stable since. Through a targeted digital and social marketing campaign, and distribution of an Asthma Triggers Brochure, the Vermont Asthma Program was able to help draw attention to the topic and help slow this trend.  Focus was also placed on identifying the triggers most common to Vermonters, including removing pets from the bedroom.  However, more work needs to be done to have providers increase their advise to youth on changing things in their environment to improve asthma control.

Eliminating or reducing exposure to asthma triggers may help reduce asthma exacerbations that may lead to missed days of school or work, and preventable ED visits and hospitalizations. Health care professionals play an important role in helping asthma patients recognize and limit their exposure to asthma triggers. The National Heart, Lung, and Blood Institute (NHLBI) EPR-3 recommends that medical professionals advise their patients with asthma to reduce or avoid exposure to indoor and outdoor asthma triggers.¹ Reduction of exposure to asthma triggers can improve asthma symptoms and reduce asthma episodes. A large part of having an Asthma Action Plan or receiving supplemental asthma self-management education is to help individuals with asthma know not only common asthma triggers, but to also be able to identify their own personal triggers and then be able to know steps to take , when possible, to remove those triggers from the home or avoid them. It is not always possible to remove or make dramatic changes in an environment because of a myriad of factors (cost, time, family pets, rental homes) but it is usually possible to make small changes that can alleviate the health impact of environmental triggers. An example would be that while getting rid of a pet that triggers asthma is not always possible, it is possible to reduce their impact by keeping pets out of the bedroom, and to make homes and cars smoke free-zones.

• Environmental Health Division is a partner that works with the Vermont Asthma Program on school based assessments to reduce triggers and improve indoor air quality.
• Vermont Department of Labor is a partner that works on the worksite wellness program.
• OneTouch is a partner that works with the Vermont Asthma Program on linking individuals to education and environmental remediation based on home visits. Other partners in the OneTouch program include Healthy Homes and Weatherization.
• Maternal and Child Health is a division in the Department of Health that works with the Vermont Asthma Program on increasing coordination at schools and among school nurses to address absenteeism and asthma education for school nurses/students, including training school nurses in selected supervisory unions throughout the state on asthma self-management.
• Blueprint for Health is a partner that works with the Vermont Asthma Program on educating community health teams on asthma education and tools available to improve self-management, including Asthma Action Plans and Healthier Living Workshops that support improving asthma management.
• Rutland Regional Medical Center has worked with the Vermont Asthma Program on home visiting programs, the MAPLE hospital discharge protocol and community education, including tobacco screening, cessation and treatment and referrals.
• DVHA is a partner that works with the Vermont Asthma Program on reducing the burden of asthma among Medicaid-insured including exploring reimbursement for community-based education.
• Vermont Department of Health Offices of Local Health are partners that work with the Vermont Asthma Program to disseminate asthma action plans and reach local communities.
• Asthma Advisory Panel is a partner made up of a cross-section of experts in diverse fields and organizations that works with the Vermont Asthma Program on developing strategic goals and relationships.
• Asthma Regional Council is a partner that works with the Vermont Asthma Program on facilitating meetings between the different New England Asthma Programs
• Northeast American Lung Association is a partner that works with the Vermont Asthma Program on supplying education materials to asthma educators within the state.
• University of Vermont: Pediatrics is a partner that works with the Vermont Asthma Program on expanding access and delivery of supplementary asthma self-management education to those with uncontrolled asthma and severe persistent asthma to prevent asthma-related emergency department visits and hospitalizations.
• Vermont Chronic Care Initiative has worked with the Vermont Asthma Program on incorporating asthma education into their case management home visiting programs.
• Vermont One Care is a partner that works with the Vermont Asthma Program at improving care for pediatric and adult populations by hosting a learning collaborative and facilitating quality improvement projects among participating providers and practices in guideline care.
• Hark Website Design, Branding & Communication is a partner that works with Vermont Asthma Program creating a digital media plan with the goal of increasing awareness of secondhand smoke exposures, increasing referrals to 802Quits, promoting importance of flu shots and asthma action plans, and reducing exposures to asthma triggers in homes and schools.

In 2007, the National Asthma Education and Prevention Program (NAEPP), coordinated by the National Heart, Lung, and Blood Institute (NHLBI), released its third set of clinical practice guidelines for asthma. The Expert Panel Report 3—Guidelines for the Diagnosis and Management of Asthma (EPR-3) that reflected the latest scientific advances in asthma drawn from a systematic review of the published medical literature by an NAEPP-convened expert panel. It continues to describes a range of generally accepted best-practice approaches for making clinical decisions about asthma care. By asking providers and care coordination teams to implement the clinical practice guidelines for asthma and to educate people with asthma on how to manage and control their asthma will result in more questions asked about the home and school environment and potential triggers. We have also seen that programs that work directly to reduce home asthma triggers, including Weatherization, and Rutland Regional Medical Center’s Pediatric In-Home Visiting Program supported through the Blueprint Community Health Team are effective ways to gain access to homes and advise individuals to change their environment. People can self refer to these type programs or can be referred, and can be especially impactful for those with allergic asthma, those sensitive to environmental factors generally, and those with uncontrolled asthma.

The Vermont Asthma Program works with clinicians and practices around the state to ensure adherence to best practice guidelines. The Vermont Asthma Program also works with partners to increase the usage of Asthma Action Plans and education provided to people with asthma.

Specific to environmental triggers, the Asthma Program promotes and is a partner within the OneTouch system – a  system for referrals primarily between home energy and weatherization contractors and health and other service providers. OneTouch reflects an important effort to strengthen coordinated care and linkages for individuals with asthma.  The Asthma Program has collaborated with the Vermont Chronic Care Initiative to assist and enhance their case managers' home visits with the goal that they will be able to address environmental triggers, administer an asthma control test, provide key messaging and supports to improve medication adherence high risk asthma individuals, and help prevent costly asthma-related hospitalizations or work disruptions. The Asthma Program will also worked with HMC advertising and more recently with HARK, to increase awareness of asthma triggers.

Data is updated as it becomes available, and timing varies by data source. For more information about this indicator, click here.