201209 Implementation of evidence-based interventions (EBIs) in school settings: The Merck Childhood Asthma Network (MCAN) experience

Wednesday, November 11, 2009: 10:30 AM

Meera Viswanathan, PhD , Health, Social, and Economics Research, RTI International, Research Triangle Park, NC
Lucia Rojas Smith, DrPH, MPH , RTI International, Washington, DC
Carol L. Woodell, BSPH , StatEpi, RTI International, Research Triangle Park, NC
Linda Lux, MPA , Health, Social, and Economics Research, RTI International, Research Triangle Park, NC
Kimberly Uyeda, MD, MPH , Student Medical Services, Los Angeles Unified School District, Los Angeles, CA
Marielena Lara, MD, MPH , RAND Health, Santa Monica, CA
Michael Rosenthal, MD , Department of Family and Community Medicine, Christiana Care Health System, Wilmington, DE
Adriana Matiz, MD , Department of Pediatrics, Columbia University College of Physicians and Surgeons, New York, NY
Vicky Persky, MD , School of Public Health, University of Illinois at Chicago, Chicago, IL
Yvonne U. Ohadike, PhD , Merck Childhood Asthma Network, Washington, DC
Julie Kennedy Lesch, MPA , Merck Childhood Asthma Network, Washington, DC
Floyd J. Malveaux, MD , Merck Childhood Asthma Network, Washington, DC
Background: Asthma continues to result in a high burden of morbidity despite existing interventions proven to improve health and quality of life. MCAN is a major new funding initiative focusing on children with moderate to severe asthma. It seeks to integrate systems and services across schools, healthcare systems, and communities and to translate proven interventions from research to practice.

Purpose: This paper highlights lessons learned in integrating care and translating EBIs across five MCAN sites (Chicago, Los Angeles, New York, Philadelphia, Puerto Rico).

Significance: Asthma management requires integration of systems and implementation of evidence-based services: the MCAN experience informs future efforts involving schools.

Methodology: Qualitative assessments of key stakeholders

Findings: The integration of systems and services, although critical to addressing the persistence of asthma, associated morbidity, and impact on school attendance, encountered numerous roadblocks: difficulty obtaining commitment from schools, financial constraints facing school districts, overburdened school nurses, competing priorities, fewer resources dedicated to nonacademic subjects, and difficulty working within the academic schedule. Modifications to interventions are often needed to successfully implement EBIs according to specific school context. MCAN sites developed creative solutions by successfully engaging school administration, converting school nurses to advocates, and working within the constraints of school schedules by modifying OAS as needed.

Conclusions: The experience of the MCAN sites illustrates the balance between translation and fidelity of EBI during the process of implementation.

Learning Objectives:
To assess the barriers and facilitators to implementing EBIs in school settings.

Keywords: Asthma, Evidence Based Practice

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Project Director for the MCAN cross-site evaluation.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.