# Implementation of a multilevel program to reduce asthma symptoms in urban preschoolers

> **NIH NIH R01** · JOHNS HOPKINS UNIVERSITY · 2024 · $743,709

## Abstract

Despite a strong evidence-base for the efficacy of asthma care intervention programs in reducing asthma
morbidity among low-income minority children, gaps remain in our understanding of how best to translate and
scale up these efficacious interventions into sustainable, broad-based programs that reduce known asthma
health disparities. Head Start (HS) serves over one million low income children each year by focusing on early
learning, physical health, and family and is committed to implementing evidence based programs to promote
overall child wellbeing. It is unknown how to best scale up and implement these evidence based asthma
interventions into low resource community organizations that serve children at risk. Implementation strategies
are frequently developed atheoretically and may not be tailored to the setting. MD ABC Asthma is a multilevel
asthma program that includes both staff and family asthma education training as well an integrated care with
medical providers. The overall purpose of this project is to inform best practices of implementation of an asthma
education program by 1) systematically evaluating the use of intervention mapping to develop a tailored
implementation strategy in partnership with Head Start stakeholders, 2) examining both staff and organizational
level determinants associated with implementation of MD ABC Asthma, and 3) evaluating the success of tailored
implementation strategies on implementation outcomes and school absences and other health outcomes.. As
part of this implementation, we will conduct a multiphase sequential mixed methods study to inform and evaluate
the implementation process using the Consolidated Framework of Implementation Research (CFIR). Aim1 will
focus on a pre-implementation evaluation of Head Start staff and directors to inform a tailored implementation
strategy using intervention mapping. Aims 2 will be an ongoing evaluation and support of the implementation
process using a sequential mixed methods approach. Aim 3 will identify both staff and organizational
determinants of implementation outcomes to inform national scalability within Head Start. Results will identify
innovative methods for implementation and sustainability in low resource settings by partnering with existing
community and government agencies as well as evaluate the impact effectiveness of an integrated multilevel
asthma program, school absences, asthma control, and healthcare utilization. Successful implementation of
this effective intervention has the potential to be included in federal guidelines and integrated into
national guidelines on management of asthma nationally through the Office of Head Start.

## Key facts

- **NIH application ID:** 10901951
- **Project number:** 5R01HL146785-05
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Michelle Nuttall Eakin
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $743,709
- **Award type:** 5
- **Project period:** 2020-08-01 → 2026-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10901951

## Citation

> US National Institutes of Health, RePORTER application 10901951, Implementation of a multilevel program to reduce asthma symptoms in urban preschoolers (5R01HL146785-05). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10901951. Licensed CC0.

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