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: 10625828
• 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/10625828
• 关键词: Absenteeism; Address; Adherence; Administrator; Advisory Committees; Affect; Area; Asthma; Award; Awareness; Black race; Caring; Chicago; Child; Childhood; Childhood Asthma; Chronic; Chronic Disease; Communication; Communities; Consolidated Framework for Implementation Research; Cost Analysis; Cost Effectiveness Analysis; Data; Data Analyses; Development; Diagnosis; Disparity; Dissemination and Implementation; Education; Effectiveness; Emergency department visit; Ensure; Face; Fostering; Foundations; Funding; Future; Goals; Guidelines; Health; High Prevalence; Home; Individual; Intervention; K-Series Research Career Programs; Knowledge; Literature; Low Income Population; Low income; 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; Policies; Population Heterogeneity; Positioning Attribute; Prevalence; Prevention; Process; Quality of life; Randomized, Controlled Trials; Reach, Effectiveness, Adoption, Implementation, and Maintenance; Readiness; Reporting; Research; Research Methodology; Research Personnel; Role; Schools; Self Efficacy; Site; Statistical Data Interpretation; Students; Symptoms; System; Training; Translating; Translational Research; Translations; Work; Youth; care providers; community based participatory research; community engaged research; cost; design; dissemination research; elementary school; evidence base; evidence based guidelines; experience; falls; future implementation; health disparity; hospitalization rates; implementation evaluation; implementation research; implementation science; improved; improved outcome; innovation; medication administration; member; novel; patient oriented; program dissemination; programs; recruit; school district; societal costs; stakeholder perspectives; 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.

项目摘要 尽管存在证据，但童年哮喘患病率和发病率仍然存在明显的健康差异 已证明可以改善结果的基于哮喘指南。学校是不可或缺的合作伙伴 哮喘管理。先前的文献已经概述了各种有针对性的基于学校的干预措施 积极的结果；但是，这些计划的重点是指南的各个组成部分，并进行 瞬时而没有整合到学校的可持续性过程中。更全面地影响 哮喘护理，学校制定了政策以支持基于指南的做法；但是，实施 跌倒不足，因此这些政策并没有导致有效的系统性实践。因此，我旨在桥接 通过制定和评估务实的多种多样，多种多样的 组成的学校定向，以儿童为中心的哮喘计划，基于现有的有针对性干预措施 并在学校融合以促进可持续性。这个创新的项目超越了现有 通过同时务实地实施哮喘的多个组成部分，以学校为基础的计划 通过外行卫生工作者领导的学校范围内的系统和简化过程的指南。我已经建立了一个 这项小说和重要研究的强大基础是与多校园建立牢固的伙伴关系 为少数族裔，低收入人口和进行初步研究的城市学校网络 突出了哮喘护理中的重要差距。在此提案中，我将开发和评估创新的多种 两所小学的组成计划（AIM 1）。首先，我将基于指南的干预 组件并确定可行性和功效（1a）。然后，我将利用这些数据和现有文献 基于学校的干预措施，以实施和评估多组件计划（1B）。关键结果将 专注于患者（哮喘控制），组织（出勤）和费用。此外，我将确定 各种利益相关者对该计划组件的看法和整体计划，作为预先的一部分 实施评估以准备在大型，多样的城市中更广泛的实施和传播 公立学区（AIM 2）。结果将用于R01研究，以扩大学校的应用 - 针对芝加哥大型，多元化的公立学区的指导，以儿童为中心的模型比较其有效性 进行其他基于学校的哮喘干预措施，并进行完整的社会成本效益分析。在此期间 职业发展奖，我将与我的导师和专家咨询委员会紧密合作 健康差异，哮喘，社区和学校计划，实施科学以及统计以及 成本分析。该奖项将使我能够在高级研究方法中获得其他必要的培训 以及数据分析以及实施和传播研究。拟议的研究和培训 将使我成为一名独立的调查员和国家领导人，他们整合了社区 - 通过实施科学进行研究，以提高患者的结果并减少哮喘差异。