# Asthma Link: A Partnership between Pediatric Practices, Schools, and Families to Improve Medication Adherence and Health Outcomes in Children with Poorly Controlled Asthma

> **NIH NIH R01** · UNIV OF MASSACHUSETTS MED SCH WORCESTER · 2024 · $746,209

## Abstract

PROJECT SUMMARY/ABSTRACT
Asthma is the most common chronic disease of childhood with significant morbidity including school absences,
poor school performance, parental lost workdays, emergency room visits and hospital admissions. The
majority of childhood asthma morbidity is due to medication non-adherence, and both morbidity and medication
non-adherence disproportionately impact low-income, Black, and Latino children.
School-supervised asthma
therapy ensures that children receive their preventive asthma medication daily at school and has shown
efficacy in improving medication adherence and asthma health outcomes, particularly in low-income and
racial/ethnic minority children. However, this strategy has not been widely adopted in practice to produce
meaningful public health impact. This is likely due to costly and resource intense protocols that have not yet
leveraged the established infrastructure of pediatric practices, schools, and families; groups that play vital roles
in the asthma health of children, yet largely work in silos. To address this gap, our team developed a new
model, Asthma Link, which partners pediatric practices, schools, and families to deliver school-supervised
asthma therapy. First, pediatric providers identify eligible children as part of their routine clinical practice and
send preventive medication orders to schools to initiate supervised asthma therapy. Next, families pick up and
deliver the asthma medication to school, and existing school staff supervise daily preventive asthma
medication use. This intervention leverages established infrastructure and requires minimal resources to
operate, enhancing sustainability in a real-world setting. Our pilot trial of Asthma Link showed improved
asthma symptoms when compared to an enhanced usual care condition, particularly among low-income, Black
and Latino children, and demonstrated trial feasibility. Moreover, we have adapted this intervention for real-
world use using input from diverse, multi-level community stakeholders. Asthma Link is now primed for an
effectiveness trial and rigorous process assessment. We propose a cluster RCT in 14 pediatric practices
(n=350 parent-child dyads) in two of the highest asthma burden cities in the nation, Worcester and Springfield,
Massachusetts. In Aim 1 we will determine the effectiveness of Asthma Link versus an enhanced usual care
condition in improving asthma health outcomes in school-aged children with poorly controlled asthma. Our
primary outcome is asthma symptoms (measured by Asthma Control Test scores) and secondary health
outcomes are adherence to inhaled corticosteroids, child and parent quality of life, emergency department
visits, hospital admissions, school absences, and parental lost workdays. Aim 2 of this study will explore the
implementation potential of Asthma Link by examining clinic, school and family-level measures of fidelity and
acceptability using mixed methods and the Proctor framework. Data collected will inform ...

## Key facts

- **NIH application ID:** 10907673
- **Project number:** 5R01HL169229-02
- **Recipient organization:** UNIV OF MASSACHUSETTS MED SCH WORCESTER
- **Principal Investigator:** Michelle Trivedi
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $746,209
- **Award type:** 5
- **Project period:** 2023-08-15 → 2028-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10907673

## Citation

> US National Institutes of Health, RePORTER application 10907673, Asthma Link: A Partnership between Pediatric Practices, Schools, and Families to Improve Medication Adherence and Health Outcomes in Children with Poorly Controlled Asthma (5R01HL169229-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10907673. Licensed CC0.

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