Despite a strong evidence-base for the efficacy of asthma care programs in reducing asthma morbidity among low-income minority children, little progress has been made implementing and sustaining interventions in at–risk communities. Effective interventions require a multi-level approach and reducing asthma disparities requires engaging community stakeholders in implementing and sustaining systems of care that reach high-risk children. Schools are an ideal location for reaching children given the strong connection to families and trust from communities. Our multi-disciplinary asthma health disparities collaborative group has a long and successful history of developing and evaluating multi-level community based interventions for asthma management tailored for urban pediatric populations. We have established a strong partnership with Baltimore City Public schools and Health Department to identify potential contributors to poor asthma control. The long-term goal is to implement an evidence-based asthma intervention based on the CDC recommended framework (EXHALE) within Baltimore City Schools. To provide the foundation for success, we will seek to identify and engage local key stakeholders, conduct a community needs assessment to inform necessary refinement and adaptations of the interventions, and build on strong partnerships with collaborative strategies to ensure successful implementation of an asthma intervention program. Results for this multi-phase project will inform the implementation of a tailored multi-level asthma intervention program (Asthma CHAMPS: Community and Home Asthma Management Program in Schools). Implementation of the Asthma CHAMPS Program will be evaluated in a pragmatic trial applying a stepped-wedge design among 32 elementary schools in Baltimore City. The conduct of this project has high potential to demonstrate a successful program that reduces asthma morbidity among Baltimore City children as well as effective implementation strategies for urban communities.

Asthma is the third leading cause for hospitalization in children and the leading cause of school absenteeism in the United States and minority children living in low-income communities have an increased burden of asthma. Effective interventions require a multi-level approach and successful implementation requires engaging community stakeholders to develop sustainable systems of care that reach high-risk children where “they live, learn, and play”. Asthma CHAMPS will implement a school- based multi-level intervention that has high potential to reduce asthma morbidity among Baltimore City children and to serve as a model approach that can be adapted to similar urban centers to eliminate asthma disparities.