Colorado Asthma-Friendly Schools: An On-ramp to Implementation Science.

Schools are a key point of intervention for child health. Children spend most of their days in school, and school nurses are well trained in the acute management of many childhood chronic diseases. The approach to asthma has changed significantly over time, with updates to inhaled corticosteroid use, the use of single inhalers for both relievers and controllers, and the increasing use of asthma biologics for managing severe asthma. Asthma specialists can play an important role in providing timely updates for school nurses about ongoing changes in overall asthma management. The purpose of this review is to summarize the evolution of our urban-centered school-based asthma program to one that has expanded into many school districts across Colorado, including rural communities, by applying principles of implementation science. We will share steps that we took to grow and scale this program as well as lessons learned during dissemination to additional school districts in Colorado. An effective school nurse-clinician interaction sets up a strong infrastructure for identifying children and adolescents who are not receiving optimal chronic disease care. Such efforts can leverage existing partnerships between schools and the healthcare system to improve the network of care for children with poorly controlled asthma.