# An Asthma Collaboration to Reduce Childhood Asthma Disparities on the Navajo Nation

> **NIH NIH U01** · NATIONAL JEWISH HEALTH · 2020 · $1,787,350

## Abstract

PROJECT SUMMARY/ABSTRACT
 Asthma prevalence among children on the Navajo Nation, the largest tribal reservation in the United
States, is 2-3 times that of the general population and fueled by health disparities that include devastating
poverty, multiple environmental pollutants, and large travel distances to obtain healthcare. Delivery of
evidence-based asthma care through the Indian Health Service (IHS), the only healthcare system on the
reservation, is inconsistent. While schools and communities identify pediatric asthma as a strong concern, no
comprehensive asthma care implementation plan has been previously introduced. Therefore, this proposed
study will combine two previously tested programs, one focused on training providers and one on school-based
education and monitoring, to build a comprehensive, integrated, team-based Asthma Care Implementation
Program to address medical care, family, home, and community to improve the health of Navajo children with
asthma. A one-year engagement phase has resulted in strong support from Navajo Nation organizations
including the President and Vice President of the Navajo Nation, governmental organizations, healthcare
centers, schools, and communities in the three participating agencies (Fort Defiance, Chinle, and Tuba City).
Approval of the proposed study by the Navajo Nation Human Research Review Board has been obtained. Key
recommendations from communities including use of existing resources such as the Navajo Epidemiology
Center, Navajo Health Department, local media, lay health workers, and ongoing involvement of stakeholders
are included in this plan. Using a stepped-wedge design, the intervention will be introduced sequentially into
three agencies. A mixed-methods analysis strategy will be employed that includes annual examination of
asthma exacerbations through the IHS database (primary outcome), interviews with 300 families with a child
with asthma, and key informant interviews with healthcare providers and school teachers and nurses. During
the sustainability phase, meetings will be held with multiple organizations including local chapter houses to
share outcome data, gather feedback, and plan for future dissemination to other agencies and reservations.
The RE-AIM framework will be employed to evaluate the implementation process and facilitate dissemination
to other tribal populations.

## Key facts

- **NIH application ID:** 9978084
- **Project number:** 5U01HL138689-04
- **Recipient organization:** NATIONAL JEWISH HEALTH
- **Principal Investigator:** Bruce George Bender
- **Activity code:** U01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $1,787,350
- **Award type:** 5
- **Project period:** 2017-08-15 → 2023-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9978084

## Citation

> US National Institutes of Health, RePORTER application 9978084, An Asthma Collaboration to Reduce Childhood Asthma Disparities on the Navajo Nation (5U01HL138689-04). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9978084. Licensed CC0.

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