Success Stories

Cross Cultural Approach to Healthy Homes Demonstration Project
University of Massachusetts Lowell

Partners

From the University of Massachusetts: Dr. Linda Silka, director of the Center for Family Work & Community and international expert in community capacity building, refugee and immigrant leadership, and community-university partnerships. Dr. Stephanie Chalupka, Professor of Nursing at the University of Massachusetts Lowell, board certified community health clinical specialist, and international expert in environmental health nursing. David Turcotte and Julie Villareal who brought significant expertise in working with non-profit and community development organizations, as well as refugee and immigrant groups. From the Lowell Health Department: Frank Singleton the Department Director.

Target Population

Lowell, Massachusetts is similar to many cities around the country in its changing demographics: nearly half of the City’s 100,000 population recently arrived as immigrants and refugees from diverse parts of the world including Africa, Brazil, Cambodia, and the Caribbean. In fact, Lowell is home to the second largest Cambodian community in the United States. Many of Lowell’s children face triple challenges of coming from homes where English is not spoken, where the family is living in poverty, and where healthy housing cannot be assumed. Housing and fire code violations, lead paint, and asbestos abound. Nurses in a variety of settings, including public health, encounter people who are at risk or already ill from illnesses with environmental links. 

Outcomes and Process

This project was designed to improve training, cross-training, cross referrals and educational outreach among many community-based and faith-based organizations that currently visit children in Lowell’s homes.

Outcomes

• Improved understanding of methods agencies currently use to address home hazards
• Increase in agencies accessing outreach worker training
• Increased understanding of how to make home visit assessments more culturally sensitive
• Increased collaboration between home visit agencies and increased understanding of the need for culturally sensitive home visits
• Use of a systematic, universal home visit assessment protocol
• Increased community awareness of methods to remediate home hazards and awareness of cross cultural home assessment programs
• Improve effectiveness of in-home visits
• Increased awareness of home hazards and remediation
• Increased knowledge of healthy Homes recommendations
• Increase in home environmental quality in Lowell

What Was Achieved:

This community university partnership enabled us to develop and test a system that can be used by other communities around the country that have large immigrant populations, high poverty rates, older substandard housing, a stressed public service system that cannot provide more services but can alter the ways in which services are shared and coordinated within a community. 

Raising Awareness:

We began our work with discussion with our partners and members of our community that culminated in a “Year of the Home Celebration.” Our activities in the ”Year of the Home included a Healthy Homes Celebration where discussed what homes mean to us and how we use them differently in our own respective cultures. For example, how useful are mattress enclosures as an intervention for asthmatics if our patients do not sleep on a mattress? Or “Why is the nurse wearing shoes in our home? We do not find that acceptable.”  

Steps in the Process:

1. Cultural audit: To more completely understand the beliefs, values and traditional practices of our community. 
2. Development of training materials to be used in development of Healthy Homes Champions in our partner agencies. Training materials included development of a Healthy Homes Assessment tool and a comprehensive resource manual specific to the City of Lowell. 
3. Training of 100 representatives of our 20 community partners. 
4. Focus groups to evaluate our training and effectiveness of the resource manual

Who Helped:

We worked with 20 community-based and faith-based organizations (e.g., Cambodian Mutual Assistance Agency, Buddhist temples, the Lowell International Center, African Assistance Center, Saint Julie Asian Center, VNA, City of Lowell Fire Department, and Lowell Community Health Center, and Coalition for a Better Acre) and 1,000 refugee or immigrant families to achieve the   outcomes identified above

This effort was funded by a Healthy Homes grant from the U.S. Department of Housing and Urban Development.

Timeline:

The entire project occurred over a 2 year period.

What’s Next?

After development, training for community partners was completed and outreach activities were underway that program was transferred to the Lowell health department to insure its sustainability.

Lessons Learned

In describing the most striking aspects of the Cross Cultural Approach to Healthy Homes collaboration, Dr. Chalupka said “I learned as much from the partner organizations and families that I worked with as they learned from our work.  In addition, questioning and challenging what appears to be ‘just the way it is’ and using collective strategies for change can empower nurses and communities to impact environmental health in communities.  

“This was one of the most satisfying experiences of my life as a public health nurse. The impact was much greater than I ever anticipated. I was overwhelmed by the interest of our community partners and the potential for change with so few resources when the intervention was culturally appropriate. The wonderful participation and enthusiasm of our partners in the community was a powerful motivating influence even when things got very challenging.” said Dr. Chalupka.

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