Understanding Core Community Needs for School-Based Asthma Programming: A Qualitative Assessment in Colorado...

Area of Science:

• Implementation Science
• Public Health
• Pediatric Asthma Management

Background:

• Asthma affects 8.5% of Colorado children, with school-based programs showing success in improving control and reducing disparities.
• Current school-based asthma programs (SBAPs) are primarily concentrated in the Denver area, limiting broader reach.
• Understanding community needs is crucial for disseminating SBAPs to other regions in Colorado.

Purpose of the Study:

• To identify community stakeholder needs for the wider implementation of school-based asthma programs (SBAPs) across Colorado.
• To explore barriers and facilitators for expanding a successful SBAP beyond its current urban concentration.
• To gather insights for tailoring SBAP dissemination strategies to diverse regional contexts.

Main Methods:

• Conducted in-depth, semistructured interviews with 52 key informants across 5 Colorado regions.
• Interviewees included school nurses, parents, healthcare providers, public health professionals, and community organization representatives.
• Employed inductive and deductive analyses guided by the practical, robust, implementation, and sustainability model.

Main Results:

• Identified six critical needs for SBAP implementation: stakeholder buy-in, asthma prioritization, enhanced inter-organizational coordination, resource availability for health and social determinants of health (SDOH), comprehensive asthma education, and improved care plan completion processes.
• These needs were categorized into a three-tiered structure: foundational, relational, and functional.
• Stakeholders highlighted the importance of addressing SDOH in conjunction with asthma management.

Conclusions:

• The identified needs provide a roadmap for optimizing SBAP delivery and implementation strategies.
• Tailoring implementation approaches to local contexts is essential for program fit, effectiveness, and long-term sustainability.
• Future efforts should focus on adapting SBAPs to meet the specific requirements of diverse communities within Colorado.