Understanding Core Community Needs for School-Based Asthma Programming: A Qualitative Assessment in Colorado Communities

Author:

Brewer Sarah E.12,Reedy Julia1,Maestas Danielle1,DeCamp Lisa Ross13,Begum Anowara1,Brtnikova Michaela13,Cicutto Lisa4,Szefler Stanley J.135,Huebschmann Amy167

Affiliation:

1. 1 ACCORDS, University of Colorado Anschutz Medical Campus, Aurora, CO

2. 2 Department of Family Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO

3. 3 Department of Pediatrics, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO

4. 4 National Jewish Health, Denver, CO

5. 5 Breathing Institute, Children’s Hospital Colorado, Aurora, CO

6. 6 Division of General Internal Medicine, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO

7. 7 Ludeman Family Center for Women’s Health Research, Anschutz Medical Campus, Aurora, CO

Abstract

Objectives Asthma is one of the most prevalent chronic conditions affecting approximately 8.5% of children in Colorado. Our school-based asthma program (SBAP) has effectively improved asthma control and reduced asthma disparities among children but has been largely limited to the Denver area. We interviewed community stakeholders in 5 regions of Colorado to understand community needs for broader dissemination of SBAPs. Methods In-depth, semistructured key informant interviews were conducted with school nurses, parents, pediatric healthcare providers, public health professionals, and community resource organization representatives. Inductive and deductive analyses were informed by the practical, robust, implementation, and sustainability model, an implementation science framework. Results Participants (n=52) identified 6 types of needs for successful future implementation of our SBAP: (1) buy-in from stakeholders; (2) asthma prioritization; (3) improved relationships, communication, and coordination among school nurses, healthcare providers, and community organizations that address social determinants of health (SDOH) and children/families; (4) resources to address healthcare and SDOH needs and awareness of existing resources; (5) asthma education for children/families, school staff, and community members; and (6) improved coordination for School Asthma Care Plan completion. These needs mapped to a 3-tiered, progressive structure of foundational, relational, and functional needs for implementation success. Conclusion These 6 types of needs illuminate factors that will allow this SBAP to work well and program delivery approaches and implementation strategies that may need modification to be successful. Next steps should include tailoring implementation strategies to variations in local context to support fit, effectiveness, and sustainment.

Publisher

Ethnicity and Disease Inc

Reference17 articles.

1. 2021 National Health Interview Survey (NHIS) Data;Centers for Disease Control and Prevention.

2. Asthma in Children;Centers for Disease Control and Prevention.,2018

3. Nocturnal asthma in children affects school attendance, school performance, and parents’ work attendance;Diette;Arch Pediatr Adolesc Med,2000

4. Asthma status and severity affects missed school days;Moonie;J Sch Health,2006

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