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Care of advanced lung disease: NIV and beyond
P274 Designing a Behavioural-Educational Intervention Using Intervention Mapping to Reduce the High Rates of Paediatric Asthma Hospital Admissions in an Inner-City Area of Birmingham
  1. F Ikram-Bashir1,
  2. L Barrett1,
  3. C Cummins2,
  4. H Pattison3
  1. 1Birmingham Children’s Hospital, Birmingham, UK
  2. 2Birmingham & Black Country Collaboration of Leadership for Applied Health Research and Care (BBC-CLAHRC) Theme 2, asthma project funded by the Heart of Birmingham (HOB) Trust, Birmingham, UK
  3. 3Aston University, Birmingham, UK

Abstract

Background Interventions based on empirically supported theory are effective in eliciting behaviour change (BC) (Michie & Prestwich, 2010). We used intervention mapping to design a BC intervention to promote effective asthma management.

Method An evidence review on BC interventions for asthma was conducted; quantitative admissions data was collated; and 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.

Findings 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) are applicable to self-management behaviours and can be translated into practical applications for asthma self-management.

Figure 1. Intervention mapping process diagram (Bartholomew et al., 2001)

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. mode of delivery, 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 Scale and Paediatric Asthma Control Test.

Discussion The intervention mapping process aided the design of an intervention tailored to a child’s own data and 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 . The next step is to implement and evaluate this intervention at Birmingham Children’s Hospital to tackle the paediatric high rates of asthma hospital admissions.

Words: 345 (excluding subheadings and diagram)

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