{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T11:29:01Z","timestamp":1782991741534,"version":"3.54.5"},"reference-count":27,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T00:00:00Z","timestamp":1768348800000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Single maintenance and reliever therapy (SMART) uses a single inhaler for daily maintenance and as\u2010needed relief. Despite evidence that SMART is more effective in reducing exacerbations than traditional therapy, it is not widely implemented. Successful SMART implementation requires participation from school health staff (SHS), who are a critical part of pediatric asthma management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using a descriptive convergent mixed methods design and grounded in the Consolidated Framework for Implementation Research, we conducted surveys and semi\u2010structured interviews with SHS to explore their perspectives on SMART implementation in schools. We calculated descriptive statistics for survey items and used rapid qualitative analysis to synthesize interview data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 11 SHS completed an interview and 22 completed a survey. Nearly all participants were familiar with SMART and 45% reported experience administering SMART. Most participants (59%) believed that SMART would be simpler for their students. In interviews, many participants highlighted that having one inhaler would also be simpler for them to manage. To support SMART implementation, communication with prescribing providers was highlighted as a primary need; 64% wanted a brief phone call with a provider, 59% wanted an email, and 82% wanted to receive a SMART\u2010specific Asthma Action Plan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>School health staff reported familiarity with SMART and confidence in their ability to administer it. Multilevel needs include clear communication from pediatric providers when children initiate SMART and availability of SMART inhalers. Future research should explore development and implementation of strategies to address these needs while integrating perspectives of providers and families.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ppul.71453","type":"journal-article","created":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T09:05:58Z","timestamp":1768381558000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["School Health Staff Perspectives on the Implementation of Single Maintenance and Reliever Therapy (SMART) for Children with Asthma"],"prefix":"10.1002","volume":"61","author":[{"given":"Melissa","family":"Goulding","sequence":"first","affiliation":[{"name":"Department of Population and Quantitative Health Sciences UMass Chan Medical School Worcester Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace","family":"Ryan","sequence":"additional","affiliation":[{"name":"Department of Population and Quantitative Health Sciences UMass Chan Medical School Worcester Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deicy","family":"Mejia","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Medicine, Department of Pediatrics UMass Chan Medical School, UMass Memorial Children's Medical Center Worcester Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Simms","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Medicine, Department of Pediatrics UMass Chan Medical School, UMass Memorial Children's Medical Center Worcester Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Spano","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Medicine, Department of Pediatrics UMass Chan Medical School, UMass Memorial Children's Medical Center Worcester Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elika","family":"Eshghi","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Medicine, Department of Pediatrics UMass Chan Medical School, UMass Memorial Children's Medical Center Worcester Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Frisard","sequence":"additional","affiliation":[{"name":"Department of Population and Quantitative Health Sciences UMass Chan Medical School Worcester Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sybil","family":"Crawford","sequence":"additional","affiliation":[{"name":"Tan Chingfen Graduate School of Nursing UMass Chan Medical School Worcester Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy","family":"Byatt","sequence":"additional","affiliation":[{"name":"Lifeline for Families Center, Department of Psychiatry UMass Chan School of Medicine Worcester Massachusetts USA"},{"name":"Department of Obstetrics and Gynecology UMass Chan Medical School Worcester Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephenie C.","family":"Lemon","sequence":"additional","affiliation":[{"name":"Department of Population and Quantitative Health Sciences UMass Chan Medical School Worcester Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Mackie","sequence":"additional","affiliation":[{"name":"School of Public Health &amp; Health Sciences University of Massachusetts Amherst Worcester Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lori","family":"Pbert","sequence":"additional","affiliation":[{"name":"Department of Population and Quantitative Health Sciences UMass Chan Medical School Worcester Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Trivedi","sequence":"additional","affiliation":[{"name":"Department of Population and Quantitative Health Sciences UMass Chan Medical School Worcester Massachusetts USA"},{"name":"Division of Pulmonary Medicine, Department of Pediatrics UMass Chan Medical School, UMass Memorial Children's Medical Center Worcester Massachusetts USA"},{"name":"Child Health Equity Center, Department of Pediatrics UMass Chan Medical School, UMass Memorial Children's Medical Center Worcester Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,14]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"CDC. 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