# Understanding the Impact of School Environment on Asthma Outcomes to Inform Implementation

> **NIH NIH F32** · JOHNS HOPKINS UNIVERSITY · 2020 · $68,544

## Abstract

Asthma is the most common pediatric chronic disease. Asthma has high morbidity in low income and minority
children and is known to be a leading cause of school absence. Despite knowledge of effective asthma
management interventions, gaps continue to exist in the implementation of asthma programs at the community
level. Implementation science, which can promote the uptake of proven interventions into routine practice, can
be a helpful tool for improving the implementation of asthma interventions with community partners such as
schools. The Environmental Protection Agency (EPA) has created Indoor Air Quality best practice
recommendations known as Tools for Schools to help improve the indoor school environment, which can
influence pediatric asthma. This proposal plans to use an implementation science model known as the
Consolidated Framework for Implementation Research (CFIR) to evaluate use of Tools for Schools
recommendations within Baltimore City Schools, with the aim of ultimately implementing a comprehensive
school based asthma management program. This study will leverage the ongoing EPA funded Baltimore City
Healthy Schools study (STAR83563901), which is investigating the impact of indoor and outdoor air quality on
student health and achievement, and has collected detailed environmental sampling in over 30 public schools
in multiple seasons as well as chronic school absence data. We plan to assess how school functions
recommended by Tools for Schools (specifically building maintenance, ventilation, integrated pest
management, and renovations and repairs) impact chronic school absences using linear regression modeling.
Through partnerships formed by the Healthy Schools study, we will survey at least one school administrator
within each school to understand asthma management practices currently occurring within schools. We will
then assess how endorsement of asthma practices in line with Tools for Schools recommendations impacts
chronic school absences through linear regression modeling. We suspect that schools with higher
endorsement of Tools for Schools recommended school functions and asthma practices will have lower
chronic school absences. The final component of our proposed study involves interviewing school stakeholders
about priorities and barriers to asthma management within their respective schools through semi-structured
phone interviews. We plan to use lessons learned from our data regarding school functions, asthma practices,
and current priorities and barriers to asthma management to implement a future comprehensive school based
asthma intervention.

## Key facts

- **NIH application ID:** 10022141
- **Project number:** 5F32HL149195-02
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Sandra Zaeh
- **Activity code:** F32 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $68,544
- **Award type:** 5
- **Project period:** 2019-07-31 → 2021-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10022141

## Citation

> US National Institutes of Health, RePORTER application 10022141, Understanding the Impact of School Environment on Asthma Outcomes to Inform Implementation (5F32HL149195-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10022141. Licensed CC0.

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