Evidence-based interventions in school health: Implementing Open Airways in urban schools

Background. Open Airways for Schools (OAS) is a well-known evidenced-based asthma educational and management program for school children. Merck Childhood Asthma Network (MCAN) sites--charged with implementing and evaluating asthma evidenced-based interventions (EBIs) in communities–-implemented OAS in urban schools.

Purpose. To highlight lessons learned and “translational dilemmas” experienced in the implementation of OAS in a national study of inner-city children.

Significance. There are few EBIs that address asthma and target schools. OAS has been disseminated and implemented nationwide, but more can be learned about the real-world “effectiveness”.

Methodology. Case study of the experience of MCAN sites using process and outcome data, both qualitative and quantitative.

Findings/Results. The MCAN sites had a range of experiences in implementing and maintaining fidelity to the OAS as originally designed. Some sites were successful in implementing the program with high fidelity; others experienced serious barriers in implementation. Barriers included difficulties in delivering the entire curriculum due to scheduling challenges, lack of proper identification of students with asthma, lack of school administrative support due to ”high stakes” testing, and others. Successful implementation strategies included, expanding the program to all children (with and without asthma) in Puerto Rico, offering the program to all children during summer school session in New York, and running the program from within the school system in Los Angeles.

Conclusions/Recommendations. MCAN sites experienced “translational dilemmas” in their implementation of OAS. Lessons learned about facilitators and barriers to this EBI can be useful to those implementing school health programs.