Chicago Asthma School-Directed Child-Centered Assessment and Dissemination of Evidence (CASCADE) Program

点击翻译按钮获取中文摘要

PROJECT ABSTRACT Significant health disparities persist in childhood asthma prevalence and morbidity despite existing evidence- based asthma guidelines that have been shown to improve outcomes. Schools are an integral partner in asthma management. Prior literature has outlined various targeted school-based interventions with some positive outcomes; however, these programs focus on individual components of the guidelines and take place transiently without integration into school processes for sustainability. To more comprehensively impact asthma care, schools have enacted policies to support guideline-based practices; however, implementation falls short and thus these policies have not led to effective, systemic practices. Therefore, I aim to bridge the gap in the implementation of asthma guidelines and policies by developing and evaluating a pragmatic, multi- component school-directed, child-centered asthma program that builds upon existing targeted interventions and is integrated in the school to foster sustainability. This innovative project contributes beyond existing school-based programs by simultaneously and pragmatically implementing multiple components of the asthma guidelines through school-wide systems and streamlined processes led by lay health workers. I have built a strong foundation for this novel and important research by developing a strong partnership with a multi-campus urban school network that serves a minority, low-income population and conducting preliminary research that highlights the important gaps in asthma care. In this proposal, I will develop and evaluate an innovative multi- component program in two elementary schools (Aim 1). First, I will pilot guideline-based intervention components and determine feasibility and efficacy (1A). I will then utilize this data and existing literature about school-based interventions to implement and evaluate a multi-component program (1B). Key outcomes will focus on the patient (asthma control), organization (school attendance), and cost. In addition, I will determine diverse stakeholder perspectives about the program components and the overall program as part of a pre- implementation assessment to prepare for broader implementation and dissemination in a large, diverse urban public school district (Aim 2).The results will be used for R01 studies that expand the application of the school- directed, child-centered model to the large, diverse public school district in Chicago, compare its effectiveness to other school-based asthma interventions, and conduct a full societal cost-effectiveness analysis. During this career development award, I will work closely with my mentors and an expert advisory committee of leaders in health disparities, asthma, community and school-based programs, implementation science, and statistical and cost analyses. This award will allow me to obtain additional necessary training in advanced research methods and data analysis, as well as implementation and dissemination research. The proposed research and training will position me to become an independent investigator and national leader who integrates community- engaged research with implementation science to advance patient outcomes and reduce asthma disparities.