Using the theoretical domains framework to identify barriers and enablers to pediatric asthma management in primary care settings

被引:19
作者
Yamada, Janet [1 ]
Potestio, Melissa L. [2 ]
Cave, Andrew J. [3 ]
Sharpe, Heather [4 ]
Johnson, David W. [5 ]
Patey, Andrea M. [6 ]
Presseau, Justin [6 ,7 ]
Grimshaw, Jeremy M. [6 ,8 ]
机构
[1] Ryerson Univ, Fac Community Serv, Daphne Cockwell Sch Nursing, 350 Victoria St, Toronto, ON M5B 2K3, Canada
[2] Univ Calgary, Dept Community Hlth Sci, Cumming Sch Med, Calgary, AB, Canada
[3] Univ Alberta, Dept Family Med, Edmonton, AB, Canada
[4] Alberta Hlth Serv, Resp Hlth Strateg Clin Network, Calgary, AB, Canada
[5] Univ Calgary, Dept Pediat Emergency Med Physiol & Pharmacol, Cumming Sch Med, Calgary, AB, Canada
[6] Ottawa Hosp, Clin Epidemiol Program, Res Inst, Ottawa, ON, Canada
[7] Univ Ottawa, Sch Epidemiol & Publ Hlth, Ottawa, ON, Canada
[8] Univ Ottawa, Dept Med, Ottawa, ON, Canada
关键词
Education; management/control; pediatrics; treatment; CANADIAN THORACIC SOCIETY; BEHAVIOR-CHANGE; CHILDREN; MEDICATION; EDUCATION; PRESCHOOLERS; FACILITATORS; PREVALENCE; ADHERENCE; DIAGNOSIS;
D O I
10.1080/02770903.2017.1408820
中图分类号
R392 [医学免疫学];
学科分类号
100102 ;
摘要
Objectives: This study aimed to apply a theory-based approach to identify barriers and enablers to implementing the Alberta Primary Care Asthma Pediatric Pathway (PCAPP) into clinical practice. Phase 1 included an assessment of assumptions underlying the intervention from the perspectives of the developers. Phase 2 determined the perceived barriers and enablers for: 1) primary care physicians' prescribing practices, 2) allied health care professionals' provision of asthma education to parents, and 3) children and parents' adherence to their treatment plans. Methods: Interviews were conducted with 35 individuals who reside in Alberta, Canada. Phase 1 included three developers. Phase 2 included 11 primary care physicians, 10 allied health care professionals, and 11 parents of children with asthma. Phase 2 interviews were based on the 14 domains of the Theoretical Domains Framework (TDF). Transcribed interviews were analyzed using a directed content analysis. Key assumptions by the developers about the intervention, and beliefs by others about the barriers and enablers of the targeted behaviors were identified. Results: Eight TDF domains mapped onto the assumptions of the pathway as described by the intervention developers. Interviews with health care professionals and parents identified nine TDF domains that influenced the targeted behaviors: knowledge, skills, beliefs about capabilities, social/professional role and identity, beliefs about consequences, environmental context and resources, behavioral regulation, social influences, and emotions. Conclusions: Barriers and enablers perceived by health care professionals and parents that influenced asthma management will inform the optimization of the PCAPP prior to its evaluation.
引用
收藏
页码:1223 / 1236
页数:14
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