Skip Navigation

Implementing Seattle-King County Healthy Homes Project

Materials and Forms to Support Implementation

Last Updated

February 2012


Operations Manuals

Documents describing guidelines for community health workers to follow to educate families and address environmental triggers of asthma are available on the project website. Each document includes information about key education messages, assessments community health workers should make during future visits, actions steps the community health workers should take to address issues, and recommended client actions. These documents include the following:

  • Basic information about asthma
  • Warning signs of asthma
  • Seeking emergency care
  • Medication adherence
  • Asthma, colds, and hand washing
  • Influenza and flu shots
  • Guidelines for communication with health care provider and working with the health care system
  • Guidelines for communication with the school and other caregivers
  • Cleaning protocol
  • Household product checklist
  • Protocol for household pets
  • Dust control guidelines
  • Dust mite guidelines
  • Moisture and mold guidelines
  • Roach guidelines
  • Rodent guidelines
  • Peak flow monitoring
  • Asthma and obesity
  • Cold home protocol
  • Clutter protocol
  • Wood smoke protocol
  • Landlord/tenant issues
  • Relocation assistance
  • Lead and asbestos protocol

In addition, community health workers developed an asthma action plan with each family.


Service Delivery Forms

Service delivery forms were used to facilitate program delivery. The forms are accessible on the project website and include the following:

  • A baseline interview form collected information about the demographics of the family and child; an assessment of asthma severity; information about health care utilization; a quality-of-life questionnaire for the child's caregiver; a self-regulation scale about efforts the child's caregiver has made to take care of the child's asthma at home; information about environmental triggers, including smoke and pollen; information about the education the child's caregiver has received from the child's doctor or other health care professional; and information about social supports available to help the caregiver cope with the child's asthma.
  • A Home Environmental Checklist was used by the CHWs to assess home environment in relation to asthma.
  • An encounter form that was used to track service delivery and to communicate with the medical provider.
  • A quarterly telephone interview questionnaire was used to track information about the child’s asthma and includes questions about asthma severity, health care utilization, and the home environment and a self-regulation scale about efforts the child's caregiver has made to take care of the child's asthma at home.
  • An exit questionnaire was used to assess program impact.


Assessment Tools

Several of the documents in the operations manual section included checklists CHWs completed while in families' homes.



The protocols listed under operations manual served as the program curriculum.


Available Languages

Materials are available in English and Spanish and some materials are available in Vietnamese.


Fidelity Measurement

No information is available.


Fidelity Standards

To document fidelity, implementing agencies were required to document adherence to education and client support protocols, visit frequency, and visit content.



The information contained on this page was last updated in February 2012. Recommended Further Reading lists the sources for this information. In addition, the information contained in this profile was reviewed for accuracy by the project director from Public Health-Seattle & King County on February 29, 2012. HomVEE reserves the right to edit the profile for clarity and consistency.