Department of Pediatrics, University of Colorado, Anschutz Medical Campus, Aurora, Colo; Children's Hospital Colorado Breathing Institute, Aurora, Colo; Adult and Child Consortium for Outcomes Research and Delivery Science (ACCORDS), University of Colorado, Anschutz Medical Campus, Aurora, Colo.
National Jewish Health, Aurora, Colo; Clinical Science and College of Nursing, University of Colorado, Anschutz Medical Campus, Aurora, Colo.
J Allergy Clin Immunol. 2022 Sep;150(3):535-548. doi: 10.1016/j.jaci.2022.04.029. Epub 2022 May 13.
Our school-based asthma program has reduced asthma exacerbations for youth with health disparities in the Denver metropolitan area, due partly to addressing social determinants of health, such as access to health care and medications. Dissemination and implementation (D&I) science approaches accelerate the translation of evidence-based programs into routine practice. D&I methods are being applied more commonly to improve health equity. The purpose of this publication was to give an overview of D&I research methods, using our school-based asthma program as an example. To successfully scale out our program across the state of Colorado, we are applying a D&I framework that guides the adaptation of our existing implementation approach to better meet our stakeholders' local context-the Exploration, Preparation, Implementation, Sustainment framework. In a pragmatic trial design, we will evaluate the outcomes of implementing the program across 5 Colorado regions, with attention to health equity, using a second commonly used D&I framework-Reach, Effectiveness, Adoption, Implementation, and Maintenance. Our central hypothesis is that our program will have broad and equitable reach to eligible students (primary outcome) and will reduce asthma attacks and symptoms. This D&I approach accelerates dissemination of our program and is an applicable process for translating other effective allergy/asthma programs to address asthma and allergy-related disparities.
我们的基于学校的哮喘项目减少了丹佛大都市区健康差距较大的青年的哮喘恶化，部分原因是解决了医疗保健和药物等健康决定因素。传播和实施（D&I）科学方法加速了将循证计划转化为常规实践。D&I 方法越来越多地被应用于改善健康公平。本出版物的目的是概述 D&I 研究方法，以我们的基于学校的哮喘项目为例。为了成功将我们的项目扩展到科罗拉多州，我们正在应用一个 D&I 框架，该框架指导我们对现有实施方法进行调整，以更好地满足利益相关者的当地情况——探索、准备、实施、维持框架。在务实的试验设计中，我们将评估在 5 个科罗拉多地区实施该计划的结果，重点关注健康公平，使用第二个常用的 D&I 框架——范围、有效性、采用、实施和维持。我们的中心假设是，我们的项目将广泛惠及符合条件的学生（主要结果），并减少哮喘发作和症状。这种 D&I 方法加速了我们项目的传播，是将其他有效的过敏/哮喘项目转化为解决哮喘和过敏相关差异的适用过程。
