From Policy to Practice: Post-implementation Perspectives on Illinois School Stock Inhaler Programming.

Abstract

School-based stock inhaler programs de-escalate asthma symptoms, yet postprogram implementation experiences of end-users remain limited. The purpose of this study was to examine school nurse and administrator perspectives on benefits, barriers, and sustainability following an Illinois pilot stock inhaler program. Twenty participants from 14 Illinois pilot schools (urban, suburban, and rural) completed semistructured postimplementation interviews. Transcripts were analyzed using thematic analysis and compared with preimplementation interviews. Participants reported reduced emergency services activation, improved school attendance, enhanced asthma identification, and reduced staff stress. Operational challenges including documentation burden, storage logistics, and caregiver communication were described as modifiable. Compared with preimplementation, participants demonstrated greater clinical confidence and normalized stock inhaler use within routine practice. Eleven repeat interviewees emphasized expanded nonhealth staff training as a priority. Stock inhaler programs are feasible and address health equity concerns in schools. Programmatic infrastructure support, training, and clear communication protocols may enhance sustainability and scalability.