Population, Policy and Practice, UCL Great Ormond Street Institute of Child Health, 30 Guildford Street, London, WC1N 1EH, UK.
Whittington Health NHS Trust, London, UK.
BMC Med Res Methodol. 2020 Nov 2;20(1):271. doi: 10.1186/s12874-020-01148-y.
To describe how using a combined approach of community-based participatory research and intervention mapping principles could inform the development of a tailored complex intervention to improve management of asthma for South Asian (SA) children; Management and Interventions for Asthma (MIA) study.
A qualitative study using interviews, focus groups, workshops, and modified intervention mapping procedures to develop an intervention planning framework in an urban community setting in Leicester, UK. The modified form of intervention mapping (IM) included: systematic evidence synthesis; community study; families and healthcare professionals study; and development of potential collaborative intervention strategies. Participants in the community study were 63 SA community members and 12 key informants; in-depth semi-structured interviews involved 30 SA families, 14 White British (WB) families and 37 Healthcare Professionals (HCPs) treating SA children living with asthma; prioritisation workshops involved 145 SA, 6 WB and 37 HCP participants; 30 participants in finalisation workshops.
Two key principles were utilised throughout the development of the intervention; community-based participatory research (CBPR) principles and intervention mapping (IM) procedures. The CBPR approach allowed close engagement with stakeholders and generated valuable knowledge to inform intervention development. It accounted for diverse perceptions and experiences with regard to asthma and recognised the priorities of patients and their families/caregivers for service improvement. The 'ACT on Asthma' programme was devised, comprising four arms of an intervention strategy: education and training, clinical support, advice centre and raising awareness, to be co-ordinated by a central team.
The modified IM principles utilised in this study were systematic and informed by theory. The combined IM and participatory approach could be considered when tailoring interventions for other clinical problems within diverse communities. The IM approach to intervention development was however resource intensive. Working in meaningful collaboration with minority communities requires specific resources and a culturally competent methodology.
描述如何使用基于社区的参与式研究和干预映射原则的综合方法为南亚(SA)儿童哮喘管理提供信息,以制定针对特定人群的复杂干预措施;管理和干预哮喘(MIA)研究。
在英国莱斯特的城市社区环境中,使用访谈、焦点小组、研讨会和修改后的干预映射程序进行定性研究,制定干预规划框架。修改后的干预映射(IM)形式包括:系统证据综合;社区研究;家庭和医疗保健专业人员研究;以及制定潜在的合作干预策略。社区研究的参与者是 63 名南亚社区成员和 12 名关键信息提供者;对 30 个南亚家庭、14 个白英国家庭和 37 名治疗南亚哮喘儿童的医疗保健专业人员进行了深入的半结构化访谈;参与优先事项研讨会的有 145 名南亚人、6 名白人和 37 名医疗保健专业人员;最终研讨会有 30 名参与者。
在干预措施的制定过程中,利用了两个关键原则;基于社区的参与式研究(CBPR)原则和干预映射(IM)程序。CBPR 方法使利益相关者密切参与,并提供了宝贵的知识,为干预措施的制定提供了信息。它考虑到了与哮喘相关的不同看法和经验,并认识到患者及其家属/照顾者对服务改进的优先事项。制定了“哮喘行动计划”方案,包括干预策略的四个方面:教育和培训、临床支持、咨询中心和提高认识,由一个中央团队协调。
本研究中使用的修改后的 IM 原则是系统的,并受到理论的启发。在为不同社区的其他临床问题量身定制干预措施时,可以考虑使用 IM 和参与式方法。然而,干预措施的发展需要大量的资源。与少数民族社区进行有意义的合作需要特定的资源和文化能力方法。