Policy to Practice: An Implementation Science-Based Approach to Stock Inhalers in Schools

Project Summary/Abstract: Candidate: This K23 award will provide an opportunity for Dr. Pappalardo to realize her goal of becoming an independently funded clinician scientist leading multi-level community-engaged implementation science interventions that dismantle persistent asthma health disparities through health policy and system-level

change. The goal of this K23 project is to test school-based asthma health policy implementation interventions in community settings with a high asthma burden. Through her research and career development plans, Dr. Pappalardo will attain expertise in the following areas: human-centered design, health policy, healthcare

administration and organizational change, and implementation science methodologies. She will do so through a combination of formal coursework, guided mentorship, and practical experience facilitated by the secured research effort. Environment: The University of Illinois Chicago (UIC) provides an ideal environment for Dr.

Pappalardo’s research career advancement. UIC’s Clinical and Translational Science Award (CTSA) program provides research services including the Biostatistics Core. The Institute for Health Research and Policy, Center for Dissemination and Implementation Science, Office of Population Health Sciences, and the health

disparities research focus of UIC’s Department of Pediatrics and Medicine provide a rich academic environment for Dr. Pappalardo to further her education. UIC houses a nationally recognized School of Public Health that provides clinician scientists online options and flexibility, which Dr. Pappalardo will leverage to earn

a Master of Public Health in Health Policy and Administration. Through these resources, Dr. Pappalardo will obtain further training in implementation science (IS), with a focus in mixed methods and multi-level intervention trial design. Dr. Pappalardo created an expert mentorship committee to guide her academic

growth. Each mentor possesses their own exceptional records of publication and funding and are all seasoned mentors to others in similar early-stage investigator roles. Research: Dr. Pappalardo will utilize community- engaged research and implementation science methods (Exploration, Preparation, Implementation and

Sustainability or EPIS determinants framework) to understand the determinants of districts who have yet to implement stock inhalers (Aim 1) and devise targeted implementation strategies through human centered design methods to address these barriers (Aim 2). Aim 3 will pilot test implementation strategies in three

schools in one to two high asthma burden Illinois counties. Dr. Pappalardo will assess process-level implementation and early effectiveness outcomes of a stock inhaler intervention in comparison to the early adopters across Illinois using the Reach Effectiveness, Adoption, Implementation and Maintenance outcomes

framework (RE-AIM). Results from Aim 3 will inform a future R01-level randomized, stepped wedge implementation trial of an asthma management program focusing on asthma medication access for children with asthma affected by health disparities in a variety of settings across Illinois.