Understanding the Impact of School Environment on Asthma Outcomes to Inform Implementation

了解学校环境对哮喘结果的影响以指导实施

• 批准号: 10022141
• 负责人: Sandra Zaeh
• 金额: $ 6.85万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-07-31 至 2021-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10022141
• 关键词: Absenteeism; Achievement; Administrator; Air; Air Pollution; Asthma; Baltimore; Behavior; Caring; Child; Childhood; Childhood Asthma; Chronic; Chronic Disease; Cities; Collection; Communities; Complex; Data; Data Analyses; Development; Disease; Enrollment; Environment; Environmental Exposure; Fellowship; Funding Agency; Future; Goals; Health; Indoor Air Quality; Indoor environment; Intervention; Interview; Knowledge; Lead; Linear Regressions; Low income; Lung diseases; Maintenance; Mentors; Minority; Modeling; Morbidity - disease rate; Nurses; Outcome; Practice Management; Public Health; Qualitative Research; Recommendation; Sampling; Schools; Scientist; Seasons; Structure; Students; Surveys; Telephone; Training; United States Environmental Protection Agency; base; career; community based participatory research; community setting; effective intervention; experience; hands on research; implementation research; implementation science; improved; minority children; programs; repaired; routine practice; teacher; tool; uptake; ventilation

Asthma is the most common pediatric chronic disease. Asthma has high morbidity in low income and minority children and is known to be a leading cause of school absence. Despite knowledge of effective asthma management interventions, gaps continue to exist in the implementation of asthma programs at the community level. Implementation science, which can promote the uptake of proven interventions into routine practice, can be a helpful tool for improving the implementation of asthma interventions with community partners such as schools. The Environmental Protection Agency (EPA) has created Indoor Air Quality best practice recommendations known as Tools for Schools to help improve the indoor school environment, which can influence pediatric asthma. This proposal plans to use an implementation science model known as the Consolidated Framework for Implementation Research (CFIR) to evaluate use of Tools for Schools recommendations within Baltimore City Schools, with the aim of ultimately implementing a comprehensive school based asthma management program. This study will leverage the ongoing EPA funded Baltimore City Healthy Schools study (STAR83563901), which is investigating the impact of indoor and outdoor air quality on student health and achievement, and has collected detailed environmental sampling in over 30 public schools in multiple seasons as well as chronic school absence data. We plan to assess how school functions recommended by Tools for Schools (specifically building maintenance, ventilation, integrated pest management, and renovations and repairs) impact chronic school absences using linear regression modeling. Through partnerships formed by the Healthy Schools study, we will survey at least one school administrator within each school to understand asthma management practices currently occurring within schools. We will then assess how endorsement of asthma practices in line with Tools for Schools recommendations impacts chronic school absences through linear regression modeling. We suspect that schools with higher endorsement of Tools for Schools recommended school functions and asthma practices will have lower chronic school absences. The final component of our proposed study involves interviewing school stakeholders about priorities and barriers to asthma management within their respective schools through semi-structured phone interviews. We plan to use lessons learned from our data regarding school functions, asthma practices, and current priorities and barriers to asthma management to implement a future comprehensive school based asthma intervention.

哮喘是儿科最常见的慢性疾病。低收入人群和少数民族哮喘发病率高 这是儿童上学的主要原因。尽管知道有效的哮喘 管理干预措施，在社区实施哮喘项目方面仍然存在差距 水平实施科学可以促进将经证实的干预措施纳入日常实践， 作为一个有用的工具，与社区合作伙伴，如 学校美国环境保护署（EPA）制定了室内空气质量最佳实践。 建议称为学校的工具，以帮助改善室内学校环境，这可以 影响小儿哮喘。该提案计划使用一种称为 评估学校工具使用情况的实施研究综合框架（CFIR） 在巴尔的摩市学校的建议，最终实施全面的目标， 学校哮喘管理项目。这项研究将利用正在进行的美国环保署资助的巴尔的摩市 健康学校研究（STAR83563901），该研究调查了室内和室外空气质量对 学生的健康和成绩，并在30多所公立学校收集了详细的环境采样 以及长期缺课的数据。我们计划评估学校如何运作 学校工具推荐（特别是建筑维护，通风，综合虫害 使用线性回归模型，评估了学校管理、翻新和维修等方面的工作对长期缺课的影响。 通过健康学校研究建立的伙伴关系，我们将调查至少一名学校管理人员 了解目前学校内发生的哮喘管理实践。我们将 然后评估支持符合学校工具建议的哮喘实践如何影响 通过线性回归模型分析长期缺课的情况。我们怀疑， 认可学校推荐的学校功能和哮喘实践工具将降低 长期缺课我们建议的研究的最后一个组成部分是采访学校的利益相关者 关于哮喘管理的优先事项和障碍，通过半结构化的 电话采访。我们计划利用我们从学校功能，哮喘实践， 以及当前哮喘管理的优先事项和障碍，以实现未来基于学校的综合性哮喘管理 哮喘干预