Evaluating the impact of a parent champion model on bronchiolitis hospitalisation rates: a difference in differences...

Bronchiolitis and its outcomes have strong socioeconomic determinants. In Liverpool, a city with high deprivation and above-average bronchiolitis hospitalisations, we implemented the Respiratory Parent Champions in the Community intervention. Parent Champions were provided with training from paediatricians and community organisations. They delivered peer support and education around bronchiolitis and modifiable risk factors in local children's centres.

Using anonymised linked electronic health records for children born in Cheshire and Merseyside 2016-2023, we used inverse probability of treatment weighted difference-in-differences methods to compare the change in monthly bronchiolitis admissions after the intervention was introduced in the intervention cohort to the change in admissions in children living in other wards in the region that had not received the intervention, adjusting for differences between populations.

Eight Respiratory Parent Champions conducted 18 050 family contacts across 16 wards in Liverpool over a 24-month period. The intervention was associated with a reduction in emergency admissions of 128 per 100 000 children per month (95% CI 43 to 214, p<0.01), in comparison to the non-intervention cohort. This equates to a 23.8% reduction in admissions or a total of 107 (95% CI 36 to 179) admissions saved per year in the intervention cohort. The preliminary estimated cost of yearly admissions saved was £219 243, with a net saving of £101 283 per annum (-£44 196 to +£248 811) after accounting for the cost of employing Parent Champions.

This study highlights the potential of a targeted community-led, co-produced intervention to alleviate healthcare burdens and address socioeconomic inequalities in infant respiratory illnesses.