Aim To develop asthma self-management programme working with children and families to prevent paediatric asthma emergency admissions in order to provide effective care and promote behaviour change (BC) towards effective management.
Method An evidence review on BC interventions for asthma was conducted; quantitative admissions data was collated; qualitative research was used to explore family and patient experiences. These were used in the six processes of intervention mapping: needs assessment, proximal programme objective matrices, theory-based methods and practical strategies, intervention design, adoption and implementation, and evaluation.
Results The six stages demonstrated that self-management behaviours are a critical component of asthma care and that childhood asthma care may be influenced through behaviour and environment. The process showed how intervention methods based on self-regulatory theory (Leventhal et al, 1984), behaviour change taxonomy (Michie & Abraham, 2008) and self-efficacy theory (Bandura, 1997) are applicable to self-management behaviours and can be translated into practical applications for asthma self-management. Step one involved conducting a literature review, collecting preliminary data and developing the asthma PRECEDE model. Step 2 highlighted the at-risk group and explores relevant theories/frameworks e.g. Asthma self-management behavioural framework (Bartholomew et al, 2001). Performance objectives and determinants were established in order to devise a change objective matrix. Step 3 linked BC techniques to determinants and change objectives in order to change behaviour. Step 4 was the intervention design targeting asthma self-management. Key features were child centred teaching including a video and facilitating family/GP links. Step 5 encompassed the logistics of the intervention i.e. delivery mode, costing and outcome expectations e.g. perceived benefits and better health. Step 6 outlined how the intervention would be evaluated including baseline and follow-ups, review of ED attendances, self-reported measures, Asthma Quality of Life Scales, Paediatric Asthma Control Test and Parental/Child Self-efficacy Scales.
Conclusion The intervention mapping process aided the design of an intervention tailored to the specific needs of a child/family. The intervention should help a child progress to more advanced asthma management and promote a tie between child/family and GP. Implementation and evaluation of this intervention in underway at Birmingham Children’s Hospital to tackle the paediatric high rates of asthma hospital admissions.