Pitt’s Healthy Home Lab
The University of Pittsburgh is one of seven institutions awarded funding through the distribution of $5.7 million in research grants from the U.S. Department of Housing and Urban Development, or HUD. The University’s Schools of Health and Rehabilitation Sciences (SHRS), Public Health and Engineering, and community partners Women for a Healthy Environment (WHE) and the Allegheny County Area Agency on Aging (AAA), received a grant of $918,709 to reduce environmental hazards in residential settings to allow more people to age safely in their homes.
The funding will be used to develop assessment tools and interventions to make homes safer for seniors, people with disabilities and other vulnerable populations. “We are excited to work with HUD and two terrific community partners to improve housing conditions for better health,” states Co-Principal Investigator and Associate Professor Dan Ding, SHRS. “Pitt recently established the Healthy Home Laboratory, a community laboratory based in a 105-year-old Pittsburgh home. This will be the perfect testbed for the HUD project.” Ding herself also currently directs the national Rehabilitation Engineering Research Center on Wireless Technologies for People with Disabilities where her team focuses on improving access to and the utilization of smart home products.
Dan Ding, associate professor, demonstrates smart home technology in the kitchen of the Healthy Home Lab
Through HUD’s grant, Pitt’s multi-disciplinary team will build a new residential environmental hazards assessment module to be added to existing home health assessments. “The current tools used in Medicare and Medicaid Home and Community Based Services (HCBS) often fail to assess the ‘health’ of the home itself,” says Ding. “They tend to focus on the functional capacity and performance of the residents or the structural modifications for home accessibility." According to Sarah Haig, co-investigator and assistant professor in the Swanson School for Engineering’s Department of Civil and Environmental Engineering, indoor air quality and the presence of mold are also important health considerations. “Mold in the home may pose a major health concern, and accurately quantifying and assessing mold risk can be a complex, expensive and time-consuming task. Our goal is to develop a simpler and less expensive mold assessment method that can provide near-real-time risk assessment,” explains Haig.
Steven M. Albert, professor and Hallen Chair, Dept. of Behavioral and Community Health Sciences, School of Public Health
“HUD notes that a ‘home is a determinant of health.’ This is especially true for older adults and people with chronic conditions and disabilities,” says Co-Principal Investigator Steven M. Albert, professor and Hallen Chair, Department of Behavioral and Community Health Sciences, School of Public Health. “Some home environments support health while others cause excess morbidity. The highly vulnerable populations receiving these services face substantial risk from unmeasured home environment hazards that may interact with their health conditions.”
The proposed two-year technical study will develop and test a cost-efficient residential hazards assessment module that can be added to current tools. “Demand for Medicaid HCBS and other health care services in the home continue to increase,” explains Jon Pearlman, who is the technical director of the Healthy Home Laboratory and chair of the Department of Rehabilitation Science and Technology in SHRS. “By developing our environmental assessment as an add-on to HCBS, it will be compatible with the current assessment process and easily scaled at the state and national levels.”
Jon Pearlman, technical director of the Healthy Home Laboratory, and chair, Dept. of Rehabilitation Science and Technology, SHRS
In 2021, over 160,000 Pennsylvanians with physical and age-associated disabilities received in-home services through Pennsylvania OPTIONS and the new Medicaid Community Health Choices (CHC) program, including many residents of Allegheny County. “This project addresses a key need to allow older adults in our county to stay safely in their homes,” commented Shannah Tharp-Gilliam, who leads the Allegheny County AAA. Albert added, “Since community agencies like the AAA and WHE deliver and oversee supportive care in the community, they are key partners for this effort, and any home environment assessment must fit within their workflow.”
The team will test the usability of the tool with AAA and WHE home health assessors and prepare training materials with these partner organizations for dissemination. “Pitt’s Healthy Home Lab (HHL) will be the key research site,” states Pearlman. “At the beginning of the project, the HHL will be used to develop real-world simulations of environmental hazards, including low temperatures, high humidity and poor indoor air quality. These simulations will be used to iteratively develop the assessment tool which will be piloted in the community.” Once the assessment tool is complete, the team will train assessors at the HHL to identify the environmental hazards simulated throughout the house.
Women for a Healthy Environment (WHE), a local organization that addresses environmental exposures that impact public health, will engage its community health workers (CHW) in piloting several aspects of the home visit experience. “The CHWs currently conduct in-home environmental health assessments to residents across the county,” explains Michelle Naccarati-Chapkis, executive director, WHE. “The assessment includes a one-on-one educational session with the resident to inform them of environmental exposures, as well as strategies to reduce or eliminate the exposures. Our role in this study will focus on piloting any new monitoring tools during our assessments that cannot fully be created in the Healthy Home Lab, and collaborating on data collection and analysis.”
The project’s outcomes could impact millions of Americans. By 2050, the U.S. population over 65 will almost double to reach 83.7 million. The majority of seniors and people with disabilities prefer to remain in their homes and age-in-place. However, according to U.S. Census Bureau, only about 10% of homes are “aging-ready.”
“HUD is a leader in addressing the health aspects of home environments and has made major gains in identifying and remediating conditions such as lead and asbestos that are linked to significant health risks.” Pearlman says, “One of the important aspects of partnering with HUD is that the agency shares our interest in developing near-term practical solutions and then supporting their implementation through community partners. This aligns perfectly with the goals of our Healthy Home Lab to develop scalable solutions to make houses safer and more age friendly.”
Published October 24, 2022
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