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dc.contributor.authorBruce, Jaime Elizabethen_US
dc.date.accessioned2015-04-24T19:43:10Z
dc.date.available2015-04-24T19:43:10Z
dc.date.issued2014
dc.date.submitted2014
dc.identifier.other
dc.identifier.urihttps://hdl.handle.net/2144/10947
dc.descriptionThesis (Dr.P.H.)--Boston Universityen_US
dc.description.abstractBackground: Tennessee made a commitment to improve the quality of care provided to children with asthma, which affects approximately 10% Tennessee's public school population. Asthma is chronic respiratory condition that can be managed with medications and behavioral and environmental interventions. Asthma action plans (AAP), which document an individual's asthma management plan, are a proven strategy associated with improved asthma outcomes. To improve the utilization of AAPs among children with asthma enrolled in public schools, the Tennessee Department of Health (TDOH) established the Tennessee Asthma Learning Collaborative (TALC), a multidisciplinary, multiagency stakeholder group that engaged in quality improvement activities at selected local sites across the state. This dissertation is an evaluation of TALC and its activities. Methods: TALC members and their community partners from local sites were interviewed about their experience participating in the learning collaborative. The Consolidated Framework for Research (CFIR) guided this qualitative data collection and analysis. AAPs were reviewed at local sites. A run chart tool was used to analyze quantitative data obtained from the review of AAPs to determine if a change in the number of forms collected occurred. Results: Participant interviews yielded information about barriers and facilitators to AAP collection in selected schools. Barriers included school nurse availability, inconsistent AAP forms across school systems, and lack of school nurse leadership at the state level. Facilitators included purposeful communication and collaboration between community healthcare providers and local school nurses. Analysis also revealed strengths and weaknesses in implementing the learning collaborative. Translation: This project informed two public health practice products. A manuscript was prepared for submission to the Journal of School Health that addresses the original state objective to reach 100% AAP compliance in schools and describes challenges related to implementing improvement strategies. A state report was produced for use by the TDOH which included recommendations for continued quality improvement efforts. Conclusion: CFIR framework provided a useful tool for evaluating the complex challenges and opportunities associated with implementing a state level multidisciplinary quality improvement effort and generated information that will inform future public health efforts to improve school-based management of chronic health conditions.en_US
dc.language.isoen_US
dc.publisherBoston Universityen_US
dc.titleApplying implementation science to improve adherence to clinical guidelines in asthma care: a public health practice dissertation to improve the utilization of asthma action plans in Tennesseeen_US
dc.typeThesis/Dissertationen_US
etd.degree.nameDoctor of Public Healthen_US
etd.degree.leveldoctoralen_US
etd.degree.disciplineMaternal and Child Healthen_US
etd.degree.grantorBoston Universityen_US


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