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.

哮喘是最常见的小儿慢性疾病。哮喘在低收入和少数群体中发病很高 儿童，众所周知是学校缺席的主要原因。尽管有有效的哮喘 管理干预措施，在社区实施哮喘计划中继续存在差距 等级。实施科学可以促进可培养的干预措施对常规实践的吸收，可以 成为改善与社区合作伙伴的哮喘干预措施的有用工具 学校。环境保护局（EPA）创建了室内空气质量最佳实践 建议为学校的工具提供建议，以帮助改善室内学校环境，这可以 影响小儿哮喘。该建议计划使用一种被称为的实施科学模型 合并实施研究框架（CFIR）评估学校使用工具 巴尔的摩市学校的建议，目的是最终实施全面 基于学校的哮喘管理计划。这项研究将利用正在进行的EPA资助的巴尔的摩市 健康学校研究（Star83563901），正在研究室内和室外空气质量的影响 学生健康和成就，并在30多所公立学校中收集了详细的环境抽样 在多个季节以及慢性学校缺席数据中。我们计划评估学校的功能 由学校的工具推荐（特别是建造维护，通风，综合害虫 管理，翻新和维修）使用线性回归建模影响慢性学校的缺勤。 通过健康学校研究建立的伙伴关系，我们将至少调查一名学校管理员 在每所学校中，了解目前在学校内发生的哮喘管理实践。我们将 然后评估对哮喘实践的认可如何符合学校建议的工具的影响 通过线性回归建模，慢性学校缺席。我们怀疑有更高的学校 支持学校工具推荐的学校职能和哮喘实践将降低 慢性学校缺席。我们拟议的研究的最终组成部分涉及采访学校利益相关者 关于通过半结构的各自学校内哮喘管理的优先事项和障碍 电话采访。我们计划使用有关学校功能，哮喘实践， 当前的优先事项和哮喘管理的障碍，以实施未来的综合学校 哮喘干预。