Fountain

This research aims to reduce asthma attacks in disadvantaged children aged 5 to 12 years who live in low-income communities in Colorado. The study evaluates two school-based asthma management programs designed to address asthma disparities, improve asthma control, and reduce missed school days. These programs also focus on social factors affecting health, such as insurance and transportation challenges, which contribute to uncontrolled asthma and poor school performance. The trial uses a hybrid implementation-effectiveness design to test and compare the two approaches in rural and small metropolitan areas across four Colorado regions. The study compares two intervention packages: BACK-Standard (BACK-S) and BACK-Enhanced (BACK-E). BACK-S includes tailored strategies to implement asthma care coordination involving students, families, schools, healthcare teams, and community agencies, supported by regular collaborative meetings among asthma navigators, school nurses, and healthcare champions. BACK-E adds enhanced community engagement to build stronger connections between students, families, schools, and community resources addressing social determinants of health. These programs are delivered over three years, with data collected on implementation and effectiveness outcomes, followed by a fourth year focused on sustainment and creating a dissemination guide for wider use. Participants are children with poorly controlled asthma enrolled in participating rural Colorado schools with high socioeconomic need. The study measures reach (how many students participate), asthma exacerbation rates, school adoption, retention, and costs. Data collection includes ongoing monitoring of asthma control, social factors, and program delivery. The trial also involves community advisory boards and multi-sector partners to tailor and sustain the programs. Overall participation lasts up to 48 months, including intervention delivery, data collection, and follow-up.