203125 Evidence-based interventions in school health: Implementing Open Airways in urban schools

Wednesday, November 11, 2009: 10:50 AM

Marielena Lara, MD, MPH , RAND Health, Santa Monica, CA
Gilberto Ramos, DrPH , Department of Biostatistics and Epidemiology, University of Puerto Rico Graduate School of Public Health, San Juan, PR
Kimberly Uyeda, MD, MPH , Student Medical Services, Los Angeles Unified School District, Los Angeles, CA
Adriana Matiz, MD , Department of Pediatrics, Columbia University College of Physicians and Surgeons, New York, NY
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.

Learning Objectives:
1) Describe important issues in the implementation of health evidenced-based interventions (EBI) in urban schools. 2) Discuss dilemmas experienced in the "translation"/implementation of these interventions, using as an example the Open Airways for School (OAS) program.

Keywords: Asthma, School-Based Programs

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am Principal Investigator for the Puerto Rico site of the MCAN (Merck Childhood Asthma Network). I have more than 10 years of experience in asthma and community-based research, having published more than 20 peer-reviewed articles.
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.