Integrating Chronic Disease and Environmental Health Education into Home Visiting Programs


Impact Statement: 
Home visiting programs are an important intervention to improve the health of women and children, but they are generally done in programmatic silos. A state health department used QI to improve the process and systematically address both chronic disease and environmental health risk factors during a home visit, standardize the assessment and referral process and enhance education. As a result, an increased percent of families received referral interventions and education related to both chronic disease and environmental health during home visits.

Several home visiting programs are funded through the state of Arizona, and multiple assessment and referral protocols that address environmental health have been used. In addition, there has been missed opportunity in home visiting programs to provide chronic disease referral and education for adults in the home. These two issues can be better addressed by integrating the environmental health and chronic disease expertise that the Arizona Department of Health Services (ADHS) has available at the state level into two state-funded home visiting programs: Health Start and the High Risk Perinatal Program (HRPP). The resulting standardized assessment process maximizes the time and effort of home visitors while they are in the home by providing them with environmental health and chronic disease resources and referral protocols. These actions will ensure positive outcomes for the clients and families enrolled in the home visiting programs.

Organization that conducted the QI initiative: 

Sjolander, S. Public Health Quality Improvement Exchange. Integrating Chronic Disease and Environmental Health Education into Home Visiting Programs . Wed, 05/28/2014 - 21:49. Available at Accessed June 22, 2024.

Submission Status: 
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Grace Gorenflo's picture
Submitted by Grace Gorenflo on

This effort is an excellent example of how to get a tremendous "bang for the buck" when conducting home visitations. Kudos on the many improvements achieved as a result of this initiative!

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Submitted by margyrob on

As funding decreases, this is a good example of how we can streamline our public health work, work across grant funding silos and still serve our communities.

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Margy Robinson MPH
HIV Care Services Mgr.
Multnomah County Health Dept.
Portland, OR

Submitted by on

Thanks for sharing your initiative! We are looking at how to integrate home visiting and case management between maternal health, environmental health and population health for things like lead poisoning prevention. This was a great example!

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Hannah Silveus, Prevention Health Specialist
CDC Public Health Associate

RiverStone Health
123 South 27th St. | Billings, MT 59101

Submitted by ChrisWing on

People suffering from chronic diseases such as heart disease, stroke, diabetes, cancer, obesity etc. has bring great limitations in daily activities which affect their life quality completely. Home care programs for such patients are highly useful that can make their life comfortable. Adaptation and the use of home care tools available at and many other sites, enable the person to do right thing at the right time in the right place. Many home care organizations provide such facilities which not only help in surviving, but help in giving some positive hopes to live long life as well.

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