Translating asthma management research to practice: Lessons learned from creating an intervention program manual

Issues:  Asthma is a chronic lung disease and a leading contributor to childhood morbidity that disproportionately affects children in low-income urban areas.  Much of the excess morbidity in asthma is related to medication non-adherence. Consequently, the National Asthma Education and Prevention Program has identified the need for effective medication adherence programs.

Description:  The Supervised Asthma Medication in Schools program was developed to provide directly observed, daily controller medications to students as part of a cost-effective, comprehensive, school-based asthma intervention. This proved to be an efficacious approach to increase medication adherence and asthma control in an ethnically diverse, low-income school system. The current project is translating the intervention from a research project into a program model for community and school partnerships to effectively administer under real-world conditions.

Lessons Learned:  Translating the program into a community intervention, we worked with local schools and the American Lung Association of Arizona to create a program guide to provide information and support materials for schools or community partners.  The guide details how to organize, maintain, and evaluate such a program. Key challenges include: perceptions of asthma as a low-priority health issue, communication with families, administrative pressures associated with standardized test performance, staffing shortages, and funding concerns. 

Recommendations: Parent and community involvement early in the project develops strong partnerships and provides opportunities to clarify goals and expectations. Strategic program evaluation can demonstrate program benefit and guide program management. Tailoring the program to each school integrates health programs into the school environment to improve chronic disease management.