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

芝加哥哮喘学校主导的以儿童为中心的评估和证据传播 (CASCADE) 计划

• 批准号: 9892223
• 负责人: Anna Volerman
• 金额: $ 18.4万
• 依托单位: UNIVERSITY OF CHICAGO
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-05-05 至 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/9892223
• 关键词: Absenteeism; Address; Adherence; Administrator; Adoption; Advisory Committees; Affect; Area; Asthma; Award; Awareness; Caring; Chicago; Child; Childhood; Childhood Asthma; Chronic; Chronic Disease; Communication; Communities; Cost Analysis; Cost Effectiveness Analysis; Data; Data Analyses; Development; Diagnosis; Education; Effectiveness; Emergency department visit; Ensure; Face; Fostering; Foundations; Funding; Future; Goals; Guidelines; Health; High Prevalence; Home environment; Individual; Intervention; K-Series Research Career Programs; Knowledge; Literature; Low Income Population; Low income; Maintenance; Mentored Patient-Oriented Research Career Development Award; Mentors; Methods; Minority; Modeling; Morbidity - disease rate; National Heart, Lung, and Blood Institute; Outcome; Parents; Patient-Focused Outcomes; Patients; Pharmaceutical Preparations; Policies; Population Heterogeneity; Positioning Attribute; Prevalence; Prevention; Process; Quality of life; Randomized Controlled Trials; Readiness; Reporting; Research; Research Methodology; Research Personnel; Research Training; Role; Schools; Self Efficacy; Site; Statistical Data Interpretation; Students; Suggestion; Symptoms; System; Time; Training; Translating; Translational Research; Translations; Work; Youth; base; care providers; community based participatory research; cost; design; dissemination research; elementary school; evidence base; evidence based guidelines; experience; falls; health disparity; hospitalization rates; implementation research; implementation science; improved; improved outcome; innovation; member; novel; patient oriented; program dissemination; programs; recruit; school district; societal costs; teacher; urban school

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.

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.