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Implementing enhanced paediatric asthma care in rural Australia: Qualitative insights from healthcare professionals
Ryan Mackle1, Carmen Crespo-Gonzalez2, Melinda Gray3
1Discipline of Paediatrics and Child Health, School of Clinical Medicine, UNSW Sydney, NSW, Australia; Department of Respiratory Medicine, Sydney Children's Hospital, Sydney Children's Hospitals Network, NSW, Australia.
Insights
Healthcare professionals found a new asthma care model feasible for rural children. This approach uses standardized resources and virtual visits to improve care consistency and access, despite some implementation challenges.
Area of Science:
- Pediatric Asthma Care
- Rural Health Implementation Science
- Healthcare Delivery Models
Background:
- Rural healthcare professionals face significant barriers in providing effective pediatric asthma care.
- Challenges include fragmented care, resource limitations, and geographic/workforce issues.
- The Asthma Care from Home project implemented a multicomponent model to address these issues in regional Australia.
Purpose of the Study:
- To explore healthcare professional perspectives on the feasibility and acceptability of a new pediatric asthma care model in rural settings.
- To assess the real-world implementation of standardized educational resources, post-discharge communication, and virtual follow-up visits.
- To identify contextual factors influencing the adoption of this model by healthcare professionals.
Main Methods:
- Qualitative study employing virtual focus groups and semi-structured interviews with 25 healthcare professionals.
- Participants were recruited from 13 hospitals across four rural Local Health Districts in New South Wales.
- Data analysis utilized a hybrid inductive-deductive thematic analysis informed by the Consolidated Framework for Implementation Research.
Main Results:
- Healthcare professionals perceived the model as acceptable, valuing standardized resources and virtual home visits for overcoming geographic barriers.
- Identified challenges included variable parental engagement, General Practitioner accessibility, and workforce instability.
- The model demonstrated success in achieving consistent, equitable care, improving guideline adherence, and enhancing hospital-community collaboration.
Conclusions:
- The implemented asthma care model was found to be feasible and acceptable by healthcare professionals in rural settings.
- The study highlights the potential for integrating this model into routine clinical practice.
- Sustained implementation may benefit from digitized resources and stronger integration into nurse-led care pathways.
Background:
Healthcare professionals (HCPs) face barriers delivering effective paediatric asthma care, particularly in rural areas due to fragmented care, resource constraints, geographic, workforce and educational challenges. As part of the Asthma Care from Home project, we implemented a multicomponent asthma model of care for children in regional Australia, comprising educational resources, post-discharge communication and nurse-led virtual follow-up visits to standardise care, improve access and reduce hospitalisations. This study explored HCP perspectives on implementation to assess real-world feasibility in rural settings.
Methods:
This qualitative study explored contextual factors influencing HCP implementation. Purposive and convenience sampled HCPs from thirteen participating hospitals across four rural New South Wales Local Health Districts participated in virtual focus groups and semi-structured interviews. Interview guides were informed by the Consolidated Framework for Implementation Research, and data were analysed using hybrid inductive-deductive thematic analysis.
Results:
Twenty-five HCPs participated in eight interviews and five focus groups. Three themes emerged: (1) Acceptability: HCPs valued standardised resources improving care consistency and virtual home visits overcoming geographic barriers, but identified challenges including variable parental engagement, General Practitioner accessibility, and workforce instability; (2) Standardisation: the model achieved consistent, equitable care with improved guideline adherence and enhanced hospital-community collaboration, strengthening HCP confidence and parent knowledge; (3) Transitioning to standard practice: participants advocated for continuation, suggesting digitised resources and greater integration into nurse-led pathways for sustainability.
Conclusion:
HCPs found the asthma care model feasible and acceptable despite rural healthcare challenges. Findings highlight the potential to embed the model within routine clinical practice in rural settings.
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