Alberta Asthma Centre, University of Alberta, Edmonton.
Can Respir J. 2013 Jul-Aug;20(4):295-300. doi: 10.1155/2013/260489.
The prevalence of asthma in Aboriginal children is 6% to 14%. Gaps in knowledge regarding asthma and its management exist in First Nations (FN) communities, and culturally relevant education and resources are required. Studies have recommended that the children's asthma education program, the 'Roaring Adventures of Puff', be modified through partnership with FN communities to be culturally appropriate.
To adapt this knowledge tool and design an effective implementation process for FN knowledge users (children with asthma and care providers), guided by the Canadian Institutes of Health Research knowledge translation framework.
The problem was identified, knowledge was identified⁄reviewed⁄selected (literature review); knowledge was adapted to the local context (FN working and advisory groups); barriers to knowledge use were assessed (by knowledge users); and interventions were selected, tailored and implemented (modified curricula and the creation of a new activity book and web-based resources, and regional coordinators, asthma educator mentors and community teams were recruited).
Major outcomes were the adapted tools and blueprints for tailoring implementation. Additional outcomes were preliminary observations and outputs from the iterative processes, including information about local context and barriers. Specific additions were roles for community members supported by asthma educators (applying FN teaching models and addressing health care demands); relevant triggers (addressing knowledge gaps); and FN images and stories, themes of circle, sacred teachings, nature and family⁄elders (culture and addressing low reading levels).
The framework model provides a logical, valuable tool for adapting a knowledge tool and implementation process to new knowledge users. Future research should measure uptake, effect on health outcomes of FN asthma sufferers and sustainability.
原住民儿童的哮喘患病率为 6%至 14%。原住民社区在哮喘及其管理方面存在知识差距，需要提供相关的教育和资源。研究建议，通过与原住民社区合作，对“吹气冒险的 puff”这一儿童哮喘教育计划进行调整，使其具有文化相关性。
根据加拿大卫生研究院知识转化框架，改编这一知识工具并设计一种针对原住民知识使用者（哮喘儿童及其护理人员）的有效实施流程。
确定问题，识别知识（文献回顾）；根据当地情况改编知识（原住民工作组和顾问组）；评估知识应用的障碍（由知识使用者评估）；选择、调整和实施干预措施（改编课程，创建新的活动手册和基于网络的资源，并招募区域协调员、哮喘教育导师和社区团队）。
主要结果是改编后的工具和定制实施的蓝图。其他结果包括迭代过程中的初步观察和产出，包括有关当地情况和障碍的信息。具体的新增内容包括得到哮喘教育者支持的社区成员的角色（应用原住民教学模式并满足医疗需求）；相关触发因素（解决知识差距）；原住民的图像和故事、圆圈主题、神圣教义、自然和家庭/长辈（文化和解决低阅读水平）。
该框架模型为改编知识工具和实施流程以适应新的知识使用者提供了一个逻辑合理、有价值的工具。未来的研究应衡量原住民哮喘患者的接受程度、对健康结果的影响和可持续性。
