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Applying dissemination and implementation research methods to translate a school-based asthma program - 05/09/22

Doi : 10.1016/j.jaci.2022.04.029 
Stanley J. Szefler, MD a, b, c, ⁎ , Lisa Cicutto, PhD, RN d, e, Sarah E. Brewer, PhD, MPA c, f, Melanie Gleason, MS, PA a, b, Arthur McFarlane, BS b, Lisa Ross DeCamp, MDMSPH a, c, g, John T. Brinton, PhD a, b, Amy G. Huebschmann, MD, MSc c, h, i
a Department of Pediatrics, University of Colorado, Anschutz Medical Campus, Aurora, Colo 
b Children’s Hospital Colorado Breathing Institute, Aurora, Colo 
c Adult and Child Consortium for Outcomes Research and Delivery Science (ACCORDS), University of Colorado, Anschutz Medical Campus, Aurora, Colo 
d National Jewish Health, Aurora, Colo 
e Clinical Science and College of Nursing, University of Colorado, Anschutz Medical Campus, Aurora, Colo 
f Department of Family Medicine, University of Colorado, Anschutz Medical Campus, Aurora, Colo 
g Latino Research and Policy Center, Colorado School of Public Health, Aurora, Colo 
h Department of Medicine, Division of General Internal Medicine, University of Colorado, Aurora, Colo 
i Ludeman Family Center for Women’s Health Research, Aurora, Colo 

∗Corresponding author: Stanley J. Szefler, MD, 13123 East 16th Ave, Box 395, Aurora, CO 80045.13123 East 16th AveBox 395AuroraCO80045

Abstract

Our school-based asthma program has reduced asthma exacerbations for youth with health disparities in the Denver metropolitan area, due partly to addressing social determinants of health, such as access to health care and medications. Dissemination and implementation (D&I) science approaches accelerate the translation of evidence-based programs into routine practice. D&I methods are being applied more commonly to improve health equity. The purpose of this publication was to give an overview of D&I research methods, using our school-based asthma program as an example. To successfully scale out our program across the state of Colorado, we are applying a D&I framework that guides the adaptation of our existing implementation approach to better meet our stakeholders’ local context—the Exploration, Preparation, Implementation, Sustainment framework. In a pragmatic trial design, we will evaluate the outcomes of implementing the program across 5 Colorado regions, with attention to health equity, using a second commonly used D&I framework—Reach, Effectiveness, Adoption, Implementation, and Maintenance. Our central hypothesis is that our program will have broad and equitable reach to eligible students (primary outcome) and will reduce asthma attacks and symptoms. This D&I approach accelerates dissemination of our program and is an applicable process for translating other effective allergy/asthma programs to address asthma and allergy-related disparities.

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Graphical abstract




Il testo completo di questo articolo è disponibile in PDF.

Key words : Asthma, dissemination and implementation research, EPIS, health disparities, PRECIS-2, PRISM, RE-AIM, social determinants of health

Abbreviations used : CAB, DECIPHeR, D&I, EPIS, NHLBI, o-SBAP, RE-AIM, SAA, SBAP, SDOH


Mappa


 Supported by the National Heart, Lung, and Blood Institute (1UG3 HL151297) Disparities Elimination through Coordinated Interventions to Prevent and Control Heart and Lung Disease Risk (DECIPHeR) Reducing Asthma Attacks in Disadvantaged School Children with Asthma; the Colorado Department of Public Health and Environment Cancer, Cardiovascular and Pulmonary Disease Program (19FHLA108325) Asthmacomp: A Comprehensive School-Centered Asthma Program; the National Heart Lung Blood Institute (K12HL137862) - Implementation to Achieve Clinical Transformation (IMPACT): The Colorado Training Program; and the National Cancer Institute (P50CA244688) – Colorado Implementation Science Center for Cancer Control and Prevention (ISC3) Pragmatic Implementation Science Approaches to Assess and Enhance Value of Cancer Prevention and Control in Rural Primary Care.
 Disclosure of potential conflict of interest: S. J. Szefler has consulted for AstraZeneca, GlaxoSmithKline, Moderna, Propeller Health, Regeneron, and Sanofi, and has received research support from the National Institutes of Health National Heart, Lung, and Blood Institute, Propeller Health, and the Colorado Department of Public Health and Environment’s Colorado Cancer, Cardiovascular and Pulmonary Disease Program. L. Cicutto, M. Gleason, and A. McFarlane received research support from the National Institutes of Health National Heart, Lung, and Blood Institute and the Colorado Department of Public Health and Environment’s Colorado Cancer, Cardiovascular and Pulmonary Disease Program. L. R. DeCamp, S. E. Brewer, and J. T. Brinton received research support from the National Institutes of Health National Heart, Lung, and Blood Institute. A. G. Huebschmann has received research support from the National Institutes of Health National Heart, Lung, and Blood Institute, the National Cancer Institute, and the National Institutes of Diabetes, Digestive and Kidney Disease.


© 2022  American Academy of Allergy, Asthma & Immunology. Pubblicato da Elsevier Masson SAS. Tutti i diritti riservati.
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