R01NR021257
Project Grant
Overview
Grant Description
Examining the effectiveness of school-based health centers (SBHCS) to improve pediatric asthma care - project summary
More than 20 million children in the US lack sufficient access to essential healthcare.
School-based health centers (SBHCS) have been broadly implemented to address this unmet need, particularly for low-income and minoritized children, by providing primary healthcare at school.
Despite proven feasibility with over 3000 SBHCS now in operation in the US, the effectiveness of SBHCS to improve health outcomes has yet to be established.
It is critical to determine the effectiveness of SBHCS to inform future investment and policy focused on SBHC expansion or modification, as well as best practices.
Our multidisciplinary team propose asthma as an ideal pediatric disease to examine SBHC effectiveness.
Asthma is the most common chronic disease in childhood, affecting more than 6 million children in the US.
It has detrimental consequences, particularly for low-income, Black and Latinx children who experience more missed school days, poor school performance, parental lost workdays, and urgent visits than their higher income and White counterparts from asthma.
This disproportionate morbidity borne by marginalized children is largely due to poor access to guideline-based asthma care and adverse social determinants of health (SDOH).
Many low-income, Black and Latinx children with asthma now receive care in SBHCS and have the potential to receive guideline-based asthma care at school.
While prior cross-sectional and small cohort studies suggest that SBHCS improve pediatric asthma outcomes, there has yet to be a large-scale examination of the effectiveness of SBHCS to improve asthma care and outcomes for marginalized children.
With traditional community health centers (CHCS) as a comparator condition, we propose to conduct an unprecedented, multi-state and longitudinal study examining the effectiveness of SBHCS to advance health equity in asthma care.
We will examine electronic health record (EHR) data from 2015-2025 in the OCHIN, Inc. data network, the largest data network of SBHCS and CHCS in the US serving >6 million low-income and vulnerable patients nationwide, including 395 SBHCS and 1280 CHCS in 16 states.
Our data network includes longitudinal measures of asthma care and outcomes with novel linkages to geographically coded SDOH data on community-level economic, environmental, and structural factors.
In Aim 1 we will determine whether SBHCS are more (or less) effective than CHCS at providing high quality asthma care and reducing asthma exacerbations among low-income children; and evaluate the potential synergy of these two settings for optimal asthma care.
In Aim 2 we will examine whether SBHCS are more (or less) effective than CHCS at improving asthma outcomes given specific adverse SDOH.
In Aim 3 we will conduct qualitative work with multi-level SBHC partners, including children/caregivers, SBHC staff and policymakers to explain quantitative findings in Aims 1 and 2.
Leveraging this unique network of SBHCS, this study provides a landmark opportunity to examine the effectiveness of SBHCS to improve pediatric asthma care for marginalized children and will inform national SBHC policy.
More than 20 million children in the US lack sufficient access to essential healthcare.
School-based health centers (SBHCS) have been broadly implemented to address this unmet need, particularly for low-income and minoritized children, by providing primary healthcare at school.
Despite proven feasibility with over 3000 SBHCS now in operation in the US, the effectiveness of SBHCS to improve health outcomes has yet to be established.
It is critical to determine the effectiveness of SBHCS to inform future investment and policy focused on SBHC expansion or modification, as well as best practices.
Our multidisciplinary team propose asthma as an ideal pediatric disease to examine SBHC effectiveness.
Asthma is the most common chronic disease in childhood, affecting more than 6 million children in the US.
It has detrimental consequences, particularly for low-income, Black and Latinx children who experience more missed school days, poor school performance, parental lost workdays, and urgent visits than their higher income and White counterparts from asthma.
This disproportionate morbidity borne by marginalized children is largely due to poor access to guideline-based asthma care and adverse social determinants of health (SDOH).
Many low-income, Black and Latinx children with asthma now receive care in SBHCS and have the potential to receive guideline-based asthma care at school.
While prior cross-sectional and small cohort studies suggest that SBHCS improve pediatric asthma outcomes, there has yet to be a large-scale examination of the effectiveness of SBHCS to improve asthma care and outcomes for marginalized children.
With traditional community health centers (CHCS) as a comparator condition, we propose to conduct an unprecedented, multi-state and longitudinal study examining the effectiveness of SBHCS to advance health equity in asthma care.
We will examine electronic health record (EHR) data from 2015-2025 in the OCHIN, Inc. data network, the largest data network of SBHCS and CHCS in the US serving >6 million low-income and vulnerable patients nationwide, including 395 SBHCS and 1280 CHCS in 16 states.
Our data network includes longitudinal measures of asthma care and outcomes with novel linkages to geographically coded SDOH data on community-level economic, environmental, and structural factors.
In Aim 1 we will determine whether SBHCS are more (or less) effective than CHCS at providing high quality asthma care and reducing asthma exacerbations among low-income children; and evaluate the potential synergy of these two settings for optimal asthma care.
In Aim 2 we will examine whether SBHCS are more (or less) effective than CHCS at improving asthma outcomes given specific adverse SDOH.
In Aim 3 we will conduct qualitative work with multi-level SBHC partners, including children/caregivers, SBHC staff and policymakers to explain quantitative findings in Aims 1 and 2.
Leveraging this unique network of SBHCS, this study provides a landmark opportunity to examine the effectiveness of SBHCS to improve pediatric asthma care for marginalized children and will inform national SBHC policy.
Funding Goals
NURSES UNDERSTAND THAT IMPROVING HEALTH AND WELL-BEING MEANS ADDRESSING PEOPLES NEEDS IN MULTIPLE SETTINGS, CONTEXTS, AND OVER THE LIFE COURSE. NINR-SUPPORTED SCIENCE USES NURSINGS HOLISTIC PATIENT AND COMMUNITY-FOCUSED PERSPECTIVE AND WIDE REACH ACROSS CLINICAL AND COMMUNITY SETTINGS TO IMPROVE INDIVIDUAL AND POPULATION HEALTH BY ADDRESSING THE CONDITIONS WHERE PEOPLE LIVE, LEARN, WORK, AND PLAY: THOSE FACTORS THAT ARE AT THE ROOT OF THE HEALTH CHALLENGES THAT WE SEE. NINR HAS A LONGSTANDING AND CONTINUED COMMITMENT TO DEVELOPING THE NEXT GENERATION OF NURSE SCIENTISTS: THOSE INDIVIDUALS AND TEAMS WHO WILL CARRY NURSING RESEARCH INTO THE FUTURE.
Grant Program (CFDA)
Awarding / Funding Agency
Place of Performance
Worcester,
Massachusetts
01655
United States
Geographic Scope
Single Zip Code
Related Opportunity
Analysis Notes
Amendment Since initial award the total obligations have increased 11% from $3,480,544 to $3,865,394.
University Of Massachusetts Medical School was awarded
Effectiveness of SBHCs for Pediatric Asthma Care
Project Grant R01NR021257
worth $3,865,394
from the National Institute of Nursing Research in April 2026 with work to be completed primarily in Worcester Massachusetts United States.
The grant
has a duration of 4 years and
was awarded through assistance program 93.361 Nursing Research.
The Project Grant was awarded through grant opportunity Effectiveness of School-Based Health Centers to Advance Health Equity (R01 Clinical Trial Optional).
Status
(Ongoing)
Last Modified 5/5/26
Period of Performance
4/16/26
Start Date
3/31/30
End Date
Funding Split
$3.9M
Federal Obligation
$0.0
Non-Federal Obligation
$3.9M
Total Obligated
Activity Timeline
Transaction History
Modifications to R01NR021257
Additional Detail
Award ID FAIN
R01NR021257
SAI Number
R01NR021257-10953008
Award ID URI
SAI UNAVAILABLE
Awardee Classifications
Public/State Controlled Institution Of Higher Education
Awarding Office
75N200 NIH National Institute of Nursing Research
Funding Office
75N200 NIH National Institute of Nursing Research
Awardee UEI
MQE2JHHJW9Q8
Awardee CAGE
6R004
Performance District
MA-02
Senators
Edward Markey
Elizabeth Warren
Elizabeth Warren
Modified: 5/5/26