Asthma Teamwork Intervention
Project Information
This project was funded by the Medical Research Council (MRC) and the UKRI Covid Extension Funding. This project was a collaboration between the University of Stirling, the University of Aberdeen, West Virginia University, and the NHS Grampian.
Background
Daily use of an asthma preventer inhaler is the most effective way to reduce symptoms and allow young people to lead a normal life. Research studies have shown that young people in particular struggle with taking their inhaler medication regularly and therefore, parental support for taking medication regularly is important. There is currently no programme in the NHS to help parents and young people to take asthma medication regularly.
PYTA (Parent Youth Teamwork Approach) is a parent-youth teamwork intervention developed and pilot-tested in the United States. Its purpose is to support young people aged 8 to 16 with asthma medication adherence and consists of four counselling sessions between a trained professional, adolescent, and parent.
Aims
Aim 1: Adapting the intervention: (a) What adaptations should be made to PYTA for it to be feasible and acceptable to adolescents with asthma, parents, and NHS HCPs in the UK?
Aim 2: Developing a novel module on peer support: (b) Which points needs to be addressed to cover the role of peers and how can this be done within the intervention delivery and materials?
Aim 3: Developing a manual to train nurses to deliver the intervention: (c) What content is needed? (d) How can the information be presented in such a way that this manual is self-explanatory?
Aim 4: Conducting a feasibility study: (e) Is PYTA-UK feasible for delivery in the UK NHS? (f) Is PYTA-UK acceptable to adolescents, parents, and HCPs?
Project Phases
The project was delivered in 3 project phases:
Phase 1) Adaption – preliminary work and focus groups.
The aim of these focus groups and interviews was to adapt the pre-existing US intervention materials for the UK-NHS context, to discuss the feasibility of the intervention (e.g., number of intervention sessions), and to generate content for the novel module on peer support. Participants in focus groups/interviews were young people with asthma (aged 8-16) with one parent/carer present as well as health care professionals (asthma nurses, paediatric asthma consultants).
The intervention was adjusted according to the feedback received in the first focus group session/interview. For the second session/interview, due to the Covid-19 pandemic, participants could choose between taking part in an online session or providing their feedback via an online questionnaire that showed the adapted materials and provided text boxes for feedback. After the second round of feedback from participants, the project team together with the University of Stirling PPI group finalized the PYTA-UK modules.
Phase 2) Producing training materials & training the nurse.
The aim of this phase was to develop a self-explanatory training manual that is easy to understand and time efficient and train an asthma nurse to deliver the intervention. Parallel to producing the final version of the intervention, the training materials for the intervention delivery had been co-produced with the asthma nurse.
Phase 3) Piloting intervention.
PYTA-UK consists of 4 modules that cover unique aspects of adherence to asthma medication in young people aged 8-16 years. The 4 thematic modules cover the following topics:
Module 1: YPs struggle for independence; Need for parent/carer involvement; Need to set realistic expectations.
Module 2: Instrumental, informational, and emotional support from parents, Positive communication strategies.
Module 3: Problem solving for conflicts around asthma management.
Module 4: Working as a team with family, doctors, and friends.
The aim of this phase was to evaluate if it is feasible and acceptable to deliver PYTA-UK in the UK-NHS. Due to the covid-19 pandemic, this project phase needed to be highly adapted and needed to be delivered as hybrid sessions. For all families, the first session was a face-to-face session and after that families could decide whether they want to meet with the asthma nurse online or face to face. All families decided to have online meetings. Meetings took place roughly every other week to allow families to have enough time to review materials between session as well as being mindful of family’s busy schedules.
Families as well as the asthma nurse filled in a short online questionnaire after each session about feasibility and acceptability of the sessions.