Project Summary/Abstract:
Candidate: This K23 award will provide an opportunity for Dr. Pappalardo to realize her goal of becoming an
independently funded clinician scientist leading multi-level community-engaged implementation science
interventions that dismantle persistent asthma health disparities through health policy and system-level
change. The goal of this K23 project is to test school-based asthma health policy implementation interventions
in community settings with a high asthma burden. Through her research and career development plans, Dr.
Pappalardo will attain expertise in the following areas: human-centered design, health policy, healthcare
administration and organizational change, and implementation science methodologies. She will do so through
a combination of formal coursework, guided mentorship, and practical experience facilitated by the secured
research effort. Environment: The University of Illinois Chicago (UIC) provides an ideal environment for Dr.
Pappalardo’s research career advancement. UIC’s Clinical and Translational Science Award (CTSA) program
provides research services including the Biostatistics Core. The Institute for Health Research and Policy,
Center for Dissemination and Implementation Science, Office of Population Health Sciences, and the health
disparities research focus of UIC’s Department of Pediatrics and Medicine provide a rich academic
environment for Dr. Pappalardo to further her education. UIC houses a nationally recognized School of Public
Health that provides clinician scientists online options and flexibility, which Dr. Pappalardo will leverage to earn
a Master of Public Health in Health Policy and Administration. Through these resources, Dr. Pappalardo will
obtain further training in implementation science (IS), with a focus in mixed methods and multi-level
intervention trial design. Dr. Pappalardo created an expert mentorship committee to guide her academic
growth. Each mentor possesses their own exceptional records of publication and funding and are all seasoned
mentors to others in similar early-stage investigator roles. Research: Dr. Pappalardo will utilize community-
engaged research and implementation science methods (Exploration, Preparation, Implementation and
Sustainability or EPIS determinants framework) to understand the determinants of districts who have yet to
implement stock inhalers (Aim 1) and devise targeted implementation strategies through human centered
design methods to address these barriers (Aim 2). Aim 3 will pilot test implementation strategies in three
schools in one to two high asthma burden Illinois counties. Dr. Pappalardo will assess process-level
implementation and early effectiveness outcomes of a stock inhaler intervention in comparison to the early
adopters across Illinois using the Reach Effectiveness, Adoption, Implementation and Maintenance outcomes
framework (RE-AIM). Results from Aim 3 will inform a future R01-level randomized, stepped wedge
implementation trial of an asthma management program focusing on asthma medication access for children
with asthma affected by health disparities in a variety of settings across Illinois.