Fig. 3

Study design for DECIPHeR Colorado program. In this diagram, there are two groupings of schools, those in GROUP A that had organizational readiness to implement either BACK-S or BACK-E in Year 1 of the funded trial, and those in GROUP B needed an additional year to prepare for implementation. The rows in each group represent the study arms for randomization. The columns are the study years, where the first column is the final year of the UG3-funded planning phase that included baseline data collection for the schools/school nurses in GROUP A, and Years 1–4 are the UH3-funded hybrid implementation-effectiveness trial period. BACK-S indicates the standard Better Asthma Control for Kids (BACK) package of implementation strategies of Tailor and adapt to context, Facilitation and Training, and BACK-E represents the enhanced strategy package of BACK-S strategies plus network weaving and consumer engagement. After 2 years of implementation, schools transition into the Maintenance phase where we will assess if they sustain either BACK-S or BACK-E, designated as MBACK-S or MBACK-E; for Arms 1 and 2 in Group B those are MBACK-S and MBACK-E, respectively