The long-term goal is to implement an evidence-based asthma intervention based on the Center for Disease Control's recommended framework (EXHALE) within Baltimore City Public Schools (BCPS). As part of a stepped wedge pragmatic trial the investigators will:
1. Evaluate the effectiveness of a tailored implementation plan of Asthma CHAMPS in 32 Baltimore city elementary schools to reduce asthma disparities. 2. Conduct a pragmatic trail using a stepped wedge design to evaluate implementation of a school and home asthma intervention program to reduce asthma-related absences, healthcare utilization and exacerbations and improve asthma control, among children enrolled in 32 Baltimore City elementary schools. 3. Use qualitative methods (observation and semi structured interviews) to obtain stakeholder feedback (parents, community health workers, school personnel and administrators) on impact of Asthma CHAMPS, identify potential refinements in intervention and implementation strategies, and evaluate impact of local adaptation and fidelity on implementation success and sustainability.
Aged 18 or older
Current caregiver of child with asthma or staff member at a Baltimore City K-8 Public School in Asthma CHAMPS
Unwilling to consent
Asthma diagnosis
Currently enrolled in Baltimore City K-8 Public School participating in Asthma CHAMPS
Unwilling to provide assent
Sequential
Asthma CHAMPS full program
BehavioralFull program includes (1) education for staff, students, and caregivers (2) environmental education and intervention (3) asthma care coordination (4) resources
Asthma CHAMPS Wait List Control
BehavioralStepped wedge design
Asthma-related absences
Administrative data from schools on attendance for child with asthma
Emergency Department (ED) utilization for asthma by children
Counts of ED visits for asthma
Hospitalization for asthma by children
Counts of hospital admissions for asthma
Oral corticosteroid steroid prescription for asthma by children
Counts of prescribed oral corticosteroids for asthma
Intervention penetration as assessed by counts
Counts of asthma education sessions for family and staff
Acceptability of Intervention (AIM) as assessed by a 4 item questionnaire
4 item measure of implementation outcome often considered "leading indicator" of implementation success. Administered on a 5 point Likert scale with higher scores indicating greater agreement with specific items.
Intervention Appropriateness Measure (IAM) as assessed by a 4 item questionnaire
4 item measure of implementation outcome often considered "leading indicator" of implementation success. Administered on a 5 point Likert scale with higher scores indicating greater agreement with specific items.
Feasibility of Intervention (FIM) as assessed by a 4 item questionnaire
4 item measure of implementation outcome often considered "leading indicator" of implementation success. Administered on a 5 point Likert scale with higher scores indicating greater agreement with specific items.
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Johns Hopkins University
Lead sponsor
Baltimore City Public Schools
Collaborator
Baltimore City Health Department
Collaborator
National Heart, Lung, and Blood Institute (NHLBI)
Collaborator
