Special Projects Fund

Grantee Name

Fund for Public Health in New York, Inc. / FPHNY

Funding Area

Special Projects Fund

Publication Date

July 2017

Grant Amount


Grant Date:

March 2014 - July 2016

In the Bronx, the number of children hospitalized for asthma-related reasons is 38% higher than the City average.

This disparity is largely associated with indoor allergens from pests, such as mice and cockroaches, which can trigger and exacerbate asthma symptoms. More than 50% of Bronx households report seeing cockroaches and mice in their homes or buildings daily. In contrast, children living in pest-free homes experience fewer asthma-related complications, from school absences to emergency room visits and hospitalizations. The Fund for Public Health in New York (FPHNY) designed an Integrated Pest Management (IPM) intervention to address the burden of asthma faced by children in the Bronx. Rather than employing pesticides, IPM eliminates pests by addressing housing conditions conducive to infestation. NYHealth supported FPHNY, in collaboration with the New York City Department of Health and Mental Hygiene (DOHMH) and Montefiore Medical Center, to rigorously evaluate its IPM intervention.

Outcomes and Lessons Learned

  • Recruited 393 children for the IPM intervention from the Bronx, northern Manhattan, and Harlem. Participating children were randomized into a control group or intervention group;
  • Conducted a randomized control trial to evaluate the IPM intervention for children between the ages of 5 and 12 years old with persistent asthma living in homes with pests; and
  • Followed participants for one year and conducted assessments at baseline, six months, and at completion.

FPHNY initially encountered recruitment challenges for the study. To address this challenge, the recruitment period was extended for six months, and the trial was expanded to include participants from northern Manhattan and Harlem. FPHNY also expanded its engagement with community-based organizations in the Bronx during the extension period.

Findings from the baseline assessment affirmed the need for an intervention:

  • In a 2-week period, participants experienced asthma symptoms for an average of 5.8 days;
  • In a 2-week period, caregivers missed an average of 1.2 days of work as a result of their child’s asthma;
  • 59% of respondents lived with both mice and cockroaches in their homes;
  • 70% reported seeing mice in the past 3 months; and
  • 89% reported seeing cockroaches each week, on average noticing 14 per day.

Preliminary results revealed that a one-time, in-home IPM intervention decreased the number of severe self-reported asthma symptoms and the average number of symptom days. Since the closing of the grant, 384 children were randomized and 342 (89%) completed both baseline and 6-month follow-up. The intervention group had a greater decrease in the percent of severe asthma symptoms than the control group, after controlling for potential confounders. The unadjusted proportion of children with severe symptoms dropped 50% in the intervention group versus 27% in controls. Future analyses will evaluate the intervention effects on health care utilization, cost-effectiveness, and return on investment to ultimately support policies for insurance reimbursement for IPM. In the meantime, members of the control group have been offered the intervention.

Montefiore and DOHMH also completed an analysis of caregiver-reported data, which showed a positive effect on symptoms for families that had the IPM intervention. They presented that data at the Pediatric Academic Societies last June. Montefiore and DOHMH have also contracted with the Global Research Analytics for Population Health group at Columbia University to use these data to perform a return-on-investment analysis.
Pending further data analyses, the City has not yet proceeded with scaling or replicating the IPM pilot.

Co-Funding and Additional Funds Leveraged: FPHNY received a grant of $600,000 from the Robin Hood Foundation to support this project.