Use of a Process Map to Evaluate the Implementation of a Community-Clinical Linked Pediatric Asthma Intervention

PurposeTo use a process map to evaluate implementation of a community-clinical linked asthma intervention.DesignFollowing the CDC Logic Model, we created a process map that outlined: (1) training community partners, (2) pediatric providers enrolling children and prescribing a second preventive inhaler, (3) families delivering the inhaler to school, (4) children visiting the school health office for daily supervised inhaler administration, and (5) ongoing communication.SettingThe trial which the present data comes from was conducted within 4 pediatric primary care practices.SampleThe study sample included pediatric providers/staff (n = 14), children (n = 31), parents (n = 31), and school health staff (n = 18).MeasuresAdherence measures were defined for each process step, using surveys and tracking data.AnalysisDescriptive and frequency statistics were calculated.ResultsAll recruited pediatric practices (n = 2) and schools (n = 46) completed training (100%, n = 48). Although delays occurred in sending medication orders from practice staff to schools, all orders were received within 6 weeks of enrollment. Children attended school health offices 92% of scheduled medication days. Providers and families reported high satisfaction with communication, though challenges existed between providers and school health staff.ConclusionUsing a process map, we were able to evaluate adherence to intended process steps and inform future adaptations to improve implementation. Process maps can be practical tools for guiding implementation evaluations and intervention adaptations.