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Table 2 Comparison of Implementation Strategies in BACK-S and BACK-E

From: Reducing asthma attacks in disadvantaged school children with asthma: study protocol for a type 2 hybrid implementation-effectiveness trial (Better Asthma Control for Kids, BACK)

DOMAINS

BACK-Standard (BACK-S)

implementation strategy package for program implementation phasea

BACK-Enhanced (BACK-E) implementation strategy package for program implementation phasea

DEFINITIONS

1. Tailor and adapt the Implementation Blueprint package of strategies – this Blueprint includes the Facilitation and Training strategies detailed here

2. Facilitation: ongoing learning communities for ANavs, nurses, and healthcare providers to support problem-solving

3. Training: asthma care management skills-building for ANavs and school nurses

BACK-Standard Strategy package (see middle column)

 + 

Enhanced strategy to engage consumers and promote network weaving at two socioecological levels:

• Community level: Promote network weaving and engagement by navigator with community social determinants of health (SDOH) resource agencies through an existing statewide network of regional health connectors

• Child/Family level: Increase engagement with child/family through school/family communication forums

ACTOR

1. Tailor and adapt: Research team with input from State and Community Advisory Boards

2. Facilitation: Research team

3. Training: Research team-directed, leveraging existing online training resources and the state health navigator program

BACK-Standard Strategy package (see middle column)

 + 

Promote network weaving: ANav + regional health connector

Increase engagement: ANav

ACTION

1. Tailor and adapt: Blueprint for how to operationalize implementation strategies will be revised annually based on recommendations from navigators, school nurses, participating families/children and health care providers

2. Facilitation: Lead problem solving within learning collaboratives for specific roles (i.e., Asthma navigator Communities of Practice and Learning (COPL), School nurse COPL, and All-Hands COPL of navigators, nurses and health care providers)

3. Training: Provide ongoing training to improve asthma care management skills, including proper inhaler technique, and the use and interpretation of asthma control assessments/Asthma Intake Form

BACK-Standard Strategy package (see left column) – including a separate learning community for BACK-E Asthma navigators

 + 

Promote network weaving: ANav meets with a regional health connector in the existing statewide network for warm handoff introductions to six local community SDOH resource agencies

Increase engagement: Asthma navigator submits six messages to a school-family forum (e.g., newsletter, school social media, or school event) to promote knowledge of local SDOH resources and accurate understanding of asthma

JUSTIFICATION

1. Tailor and Adapt: Informed by our EPIS and PRISM/RE-AIM implementation science frameworks

2. Facilitation: Critical for implementing our BACK program in past schools

3. Training: Critical for implementing our BACK program in past schools

Evidence from the literature [48, 49] and Community Advisory Board recommendations for this strategy to impact Reach and Equity

  1. aStrategies in this table are for the Implementation phase (UH3 Trial Years 1–3) for schools served by school nurses randomized to either BACK-Standard or BACK-Enhanced
  2. The implementation strategies for the planning phase (UG3 Planning phase years 2–3 and UH3 Trial Year 1) are common to both BACK-Standard and BACK-Enhanced and are not displayed here. For reference, those planning phase strategies were also part of the implementation blueprint developed in the planning phase and included training; engaging consumers; supporting clinician teams in schools and healthcare through development of communication templates and other resources stored in an online implementation guide; change infrastructure included development of online resource to support asthma case management by facilitating triage of asthma severity and supporting audit and feedback
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Implementation Science

ISSN: 1748-5908