{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T10:38:36Z","timestamp":1789468716420,"version":"build-2803163510"},"reference-count":14,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:00:00Z","timestamp":1788825600000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["U01HL138687"],"award-info":[{"award-number":["U01HL138687"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of School Health"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Racially minoritized and economically disadvantaged children are disproportionately affected by asthma and often receive less or lower quality care. This paper describes the implementation of a community health worker (CHW)\u2010delivered program in the School District of Philadelphia, asthma management challenges in under\u2010resourced schools, and provides potential solutions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Contributions to Practice<\/jats:title>\n                    <jats:p>Implementation outcomes for two school\u2010based interventions were evaluated to inform sustainment. Ten school nurses and administrators participated in semi\u2010structured interviews about intervention experience, sustainment, resource gaps, and supports needed to continue the interventions. The research team observed intervention delivery and rated fidelity. Medication management, education, and coordination costs for nurses and CHWs were estimated and annualized over a 180\u2010day school year. Interviews identified five themes: (1) barriers, (2) facilitators, (3) recommendations, (4) successes\/impacts, and (5) sustainment. Lesson fidelity was measured across 7 schools and varied across lessons. CHW (\u2248$3366\/school) and nurse costs (\u2248$1620\/school) differed by over $70,000.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications for School Health Policy, Practice, and Equity<\/jats:title>\n                    <jats:p>Care coordination, community partnerships, and reimbursement for CHW\u2010supported programs in public schools should be instituted to implement and sustain asthma interventions and improve care access for racially minoritized and economically disadvantaged children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Despite nurses' and\/or administrators' satisfaction with the intervention, it was not sustainable without\n                      <jats:styled-content style=\"fixed-case\">CHWs<\/jats:styled-content>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/josh.70229","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T07:24:58Z","timestamp":1788852298000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Lessons Learned About the Implementation and Sustainability of a Community\u2010Driven Asthma Intervention in Public Schools"],"prefix":"10.1111","volume":"96","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6384-5698","authenticated-orcid":false,"given":"Liza","family":"Tomczuk","sequence":"first","affiliation":[{"name":"Dornsife School of Public Health Drexel University  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1924-0269","authenticated-orcid":false,"given":"Melanie","family":"Pellecchia","sequence":"additional","affiliation":[{"name":"Perelman School of Medicine, University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4323-0175","authenticated-orcid":false,"given":"Freya","family":"Nezir","sequence":"additional","affiliation":[{"name":"Perelman School of Medicine, University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1606-989X","authenticated-orcid":false,"given":"Hanna","family":"Christian","sequence":"additional","affiliation":[{"name":"Perelman School of Medicine, University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5683-3616","authenticated-orcid":false,"given":"Tyra","family":"Bryant\u2010Stephens","sequence":"additional","affiliation":[{"name":"Children's Hospital of Philadelphia  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9542-2801","authenticated-orcid":false,"given":"Courtney Benjamin","family":"Wolk","sequence":"additional","affiliation":[{"name":"Perelman School of Medicine, University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,8]]},"reference":[{"key":"e_1_2_12_2_1","unstructured":"Centers for Disease Control and Prevention \u201cMost Recent National Asthma Data|CDC \u201d(2021) https:\/\/www.cdc.gov\/asthma\/most_recent_national_asthma_data.htm."},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2022.1457"},{"issue":"3","key":"e_1_2_12_4_1","first-page":"497","article-title":"An Overview of Health Disparities in Asthma","volume":"94","author":"Perez M. F.","year":"2021","journal-title":"Yale Journal of Biology and Medicine"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2021.0667"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2542\u20105196(22)00302\u20103"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/1367493510397680"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201003\u20100429OC"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1080\/02770903.2024.2313146"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.conctc.2021.100864"},{"key":"e_1_2_12_11_1","unstructured":"K.GarciaandPhiladelphia City Council \u201cPhiladelphia Tax Reform Commission Unveils Recommendations to Reduce Poverty and Create Economic Opportunity For Philadelphians \u201d(2025) https:\/\/phlcouncil.com\/philadelphia\u2010tax\u2010reform\u2010commission\u2010unveils\u2010recommendations\u2010to\u2010reduce\u2010poverty\u2010and\u2010create\u2010economic\u2010opportunity\u2010for\u2010philadelphians\/."},{"key":"e_1_2_12_12_1","unstructured":"The Pew Chartiable Trusts \u201cThe State of Philadelphians Living in Poverty \u201d(2019) https:\/\/www.pew.org\/\u2010\/media\/assets\/2019\/05\/state_of_poverty.pdf."},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13012\u2010018\u20100842\u20106"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.5888\/pcd13.160129"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/1059840518805824"}],"container-title":["Journal of School Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/josh.70229","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/josh.70229","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/josh.70229","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T09:04:52Z","timestamp":1789463092000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/josh.70229"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":14,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1111\/josh.70229"],"URL":"https:\/\/doi.org\/10.1111\/josh.70229","archive":["Portico"],"relation":{},"ISSN":["0022-4391","1746-1561"],"issn-type":[{"value":"0022-4391","type":"print"},{"value":"1746-1561","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]},"assertion":[{"value":"2025-09-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-01","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70229"}}