Implementation of a multilevel program to reduce asthma symptoms in urban preschoolers

实施多层次计划以减少城市学龄前儿童的哮喘症状

• 批准号: 10678876
• 负责人: Michelle Nuttall Eakin
• 金额: $ 75.91万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-01 至 2025-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10678876
• 关键词: Address; Adherence; Adoption; Adrenal Cortex Hormones; Agreement; Asthma; Baltimore; Caring; Characteristics; Child; Child Development; Child Welfare; Cities; Communities; Consolidated Framework for Implementation Research; County; Data; Education; Effectiveness; Evaluation; Evidence based intervention; Evidence based program; Family; Focus Groups; Frequencies; Government Agencies; Guidelines; Head Start Program; Health; Human Resources; Individual; Intervention; Knowledge; Learning; Link; Low income; Maryland; Measures; Medical; Methods; Morbidity - disease rate; Nursery Schools; Oral; Outcome; Penetration; Pharmaceutical Preparations; Phase; Program Sustainability; Provider; Research; Resource-limited setting; Resources; Risk; Schools; Self Efficacy; Self Management; Services; Site; Surveys; Symptoms; Theory of Change; Training; Training and Education; Translating; Variant; care coordination; community organizations; design; effective intervention; efficacious intervention; evidence base; health care service utilization; health disparity; implementation determinants; implementation evaluation; implementation facilitators; implementation outcomes; implementation process; implementation strategy; improved; innovation; integrated care; intervention mapping; intervention program; minority children; organizational readiness; physical conditioning; primary care provider; programs; satisfaction; scale up; screening; success; systematic review

Despite a strong evidence-base for the efficacy of asthma care intervention programs in reducing asthma morbidity among low-income minority children, gaps remain in our understanding of how best to translate and scale up these efficacious interventions into sustainable, broad-based programs that reduce known asthma health disparities. Head Start (HS) serves over one million low income children each year by focusing on early learning, physical health, and family and is committed to implementing evidence based programs to promote overall child wellbeing. It is unknown how to best scale up and implement these evidence based asthma interventions into low resource community organizations that serve children at risk. Implementation strategies are frequently developed atheoretically and may not be tailored to the setting. MD ABC Asthma is a multilevel asthma program that includes both staff and family asthma education training as well an integrated care with medical providers. The overall purpose of this project is to inform best practices of implementation of an asthma education program by 1) systematically evaluating the use of intervention mapping to develop a tailored implementation strategy in partnership with Head Start stakeholders, 2) examining both staff and organizational level determinants associated with implementation of MD ABC Asthma, and 3) evaluating the success of tailored implementation strategies on implementation outcomes and school absences and other health outcomes.. As part of this implementation, we will conduct a multiphase sequential mixed methods study to inform and evaluate the implementation process using the Consolidated Framework of Implementation Research (CFIR). Aim1 will focus on a pre-implementation evaluation of Head Start staff and directors to inform a tailored implementation strategy using intervention mapping. Aims 2 will be an ongoing evaluation and support of the implementation process using a sequential mixed methods approach. Aim 3 will identify both staff and organizational determinants of implementation outcomes to inform national scalability within Head Start. Results will identify innovative methods for implementation and sustainability in low resource settings by partnering with existing community and government agencies as well as evaluate the impact effectiveness of an integrated multilevel asthma program, school absences, asthma control, and healthcare utilization. Successful implementation of this effective intervention has the potential to be included in federal guidelines and integrated into national guidelines on management of asthma nationally through the Office of Head Start.

尽管有强烈的证据表明哮喘护理干预计划在减少哮喘方面的功效 低收入少数民族儿童的发病率，我们对如何最好地翻译和 将这些有效的干预措施扩展到可持续的，基于广泛的计划，以减少已知的哮喘 健康差异。 Head Start（HS）每年都会专注于早期，每年为超过一百万的低收入儿童服务 学习，身体健康和家庭，并致力于实施基于证据的计划以促进 总体儿童健康。未知如何最好地扩展和实施这些基于证据的哮喘 干预为有风险的儿童提供服务的低资源社区组织。实施策略 经常在理论上开发，并且可能不会针对设置量身定制。 MD ABC哮喘是多层次 哮喘计划包括员工和家庭哮喘教育培训，以及与 医疗提供者。该项目的总体目的是为实施哮喘的实施提供最佳实践 教育计划1）系统地评估使用干预映射来开发量身定制的 实施策略与Head Start利益相关者合作，2）检查员工和组织 与实施MD ABC哮喘相关的水平决定因素，以及3）评估量身定制的成功 实施实施成果和学校缺勤以及其他健康成果的策略。 该实施的一部分，我们将进行多相顺序混合方法研究，以告知和评估 使用实施研究（CFIR）的合并框架的实施过程。 AIM1将 专注于负责人和董事的实施前评估，以告知量身定制的实施 使用干预映射的策略。目标2将是对实施的持续评估和支持 使用顺序混合方法方法进行处理。 AIM 3将确定员工和组织 实施成果的决定因素，以告知头部开始内的国家可伸缩性。结果将确定 通过与现有 社区和政府机构以及评估综合多层次的影响力 哮喘计划，缺勤，哮喘控制和医疗保健利用。成功实施 这种有效的干预措施有可能纳入联邦准则，并将其整合到 全国范围内通过Head Start办公室在全国范围内管理哮喘的国家指南。