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

基本信息

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
项目类别：
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

项目摘要

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.

尽管有强有力的证据表明哮喘护理干预计划在减少哮喘方面的功效尽管低收入少数族裔儿童的发病率很高，但我们对如何最好地转化和治疗的理解仍然存在差距。将这些有效的干预措施扩大到可持续的、基础广泛的项目中，以减少已知的哮喘健康差异。 Head Start (HS) 每年为超过一百万低收入儿童提供服务，重点关注早期教育学习、身体健康和家庭，并致力于实施基于证据的计划，以促进儿童的整体福祉。目前尚不清楚如何最好地扩大和实施这些基于证据的哮喘对为高危儿童服务的资源匮乏的社区组织进行干预。实施策略经常是在理论上发展的，并且可能不适合环境。 MD ABC 哮喘是一种多层次的疾病哮喘计划，包括工作人员和家庭哮喘教育培训以及综合护理医疗提供者。该项目的总体目的是提供实施哮喘的最佳实践教育计划通过 1) 系统地评估干预图的使用，以制定量身定制的与 Head Start 利益相关者合作实施战略，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) 评估定制方案的成功与否关于实施结果、缺勤和其他健康结果的实施战略。作为该实施的一部分，我们将进行多阶段顺序混合方法研究，以告知和评估使用实施研究综合框架（CFIR）的实施过程。目标1将重点关注 Head Start 员工和主管的实施前评估，为量身定制的实施提供信息使用干预映射的策略。目标 2 将是持续评估和支持实施使用顺序混合方法的过程。目标 3 将确定工作人员和组织实施结果的决定因素，以告知 Head Start 中的国家可扩展性。结果将确定通过与现有的伙伴合作，在资源匮乏的环境中实施和可持续性的创新方法社区和政府机构以及评估综合多层次的影响效果哮喘计划、学校缺勤、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被纳入联邦指导方针并纳入通过 Head Start 办公室在全国范围内制定关于哮喘管理的国家指南。