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Integrating evidence-based paediatric asthma management in Australian primary care: phase I protocol for developing
Ashraful Kabir1, Md Ariful Islam1, Shirdhya Joypaul2
1Discipline of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Medicine, UNSW Sydney, Randwick, NSW, Australia.
Insights
This study develops an asthma Implementation Bundle for Australian general practices to improve guideline-concordant paediatric asthma care. The research focuses on co-design and tailoring strategies for better implementation in primary health settings.
Area of Science:
- Implementation Science
- Paediatric Respiratory Medicine
- General Practice Research
Background:
- Asthma is a common chronic respiratory condition in Australian children.
- Adherence to paediatric asthma care guidelines in general practice is suboptimal, estimated below 60% in some areas.
- The National Paediatric Applied Research Translation Initiative (N-PARTI) aims to improve care for priority conditions, including asthma.
Purpose of the Study:
- To outline Phase I of the N-PARTI asthma stream, focusing on developing an Implementation Bundle for evidence-based paediatric asthma management in general practices.
- To refine a multicomponent asthma Implementation Bundle through evidence synthesis and co-design workshops.
- To map clinical workflows and explore contextual factors in Primary Health Networks to inform tailored implementation strategies.
Main Methods:
- A mixed-method, co-design approach involving children with asthma, parents, carers, and stakeholders.
- Evidence synthesis and co-design workshops to verify and refine the Implementation Bundle.
- Interviews and observations using Functional Resonance Analysis Method (FRAM) to map clinical workflows.
- Stakeholder interviews and reflexive thematic analysis informed by the Consolidated Framework for Implementation Research (CFIR) to explore contextual factors.
Main Results:
- Development of a refined, contextually adapted paediatric asthma Implementation Bundle.
- Identification of variations in routine practice and contextual factors influencing implementation.
- Creation of resources to support real-world simulation, testing, tailoring, scale-up, and evaluation in subsequent phases.
Conclusions:
- Phase I successfully developed a co-designed asthma Implementation Bundle tailored for Australian general practices.
- The findings will inform Phase II (simulation and testing) and Phase III (scale-up and evaluation) of the N-PARTI program.
- This research aims to optimize guideline-concordant paediatric asthma care in primary health settings.
Introduction:
Asthma is the most common chronic respiratory condition among Australian children. However, adherence to clinical guidelines for paediatric asthma care in general practice (GP) settings requires attention-it is estimated to be below 60% in some contexts. The National Paediatric Applied Research Translation Initiative (N-PARTI) is a three-phased, co-designed research program aiming to optimise guideline-concordant paediatric care across three priority conditions, including asthma, Type 1 Diabetes (T1D), and antibiotic stewardship in Australian general practices. This protocol outlines Phase I of the N-PARTI asthma stream, focusing on developing an Implementation Bundle to support evidence-based asthma management in general practices.
Methods And Analysis:
Using a mixed-method design, Phase I will employ a multi-method, co-design approach comprising three Aims: (i) to verify and refine a multicomponent asthma Implementation Bundle tailored for general practice through evidence synthesis, and co-design workshops, involving children with asthma and their parents and carers, alongside with key stakeholders; (ii) to map asthma-related clinical workflows across diverse general practice settings through interviews and observations, analysed using the Functional Resonance Analysis Method (FRAM) to capture variations in routine practice; and (iii) to explore contextual factors within Primary Health Networks (PHNs) through stakeholder interviews, informing the development of locally tailored implementation strategies. Qualitative data will be analysed using a reflexive thematic analysis approach informed by the Consolidated Framework for Implementation Research (CFIR). Outputs will include a refined, contextually adapted paediatric asthma Implementation Bundle and resources to support real-world simulation, testing and tailoring (Phase II), as well as the scale-up, embedding and evaluation of the implementation (Phase III).
Ethics And Dissemination:
This research project has been approved by the Macquarie University Human Research Ethics Committee (Reference No. 520251855660911). Findings will be disseminated through peer-reviewed publications, conferences, stakeholder forums, and policy briefings. Co-designed outputs will also be shared with participating PHNs to inform wider implementation and scale-up efforts.
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