Planning a digital intervention for adolescents with asthma (BREATHE4T): A theory-, evidence- and Person-Based Approach to identify key behavioural issues

Stephanie Easton; Ben Ainsworth; Mike Thomas; Sue Latter; Rebecca Knibb; Amber Cook; Sam Wilding; Michael Bahrami-Hessari; Erika Kennington; Denise Gibson; Hannah Wilkins; Lucy Yardley; Graham Roberts

doi:10.1002/ppul.26099

Planning a digital intervention for adolescents with asthma (BREATHE4T): A theory-, evidence- and Person-Based Approach to identify key behavioural issues

Pediatr Pulmonol. 2022 Nov;57(11):2589-2602. doi: 10.1002/ppul.26099. Epub 2022 Sep 6.

Authors

Stephanie Easton^{1

2}, Ben Ainsworth³, Mike Thomas⁴, Sue Latter⁵, Rebecca Knibb⁶, Amber Cook¹, Sam Wilding⁷, Michael Bahrami-Hessari¹, Erika Kennington⁸, Denise Gibson⁹, Hannah Wilkins⁹, Lucy Yardley¹⁰, Graham Roberts^{1

2}

Affiliations

¹ NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
² Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK.
³ Department of Psychology, Faculty of Humanities and Social Sciences, University of Bath, Bath, UK.
⁴ Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.
⁵ School of Health Sciences, University of Southampton, Southampton, UK.
⁶ School of Psychology, College of Health and Life Sciences, University of Aston, Birmingham, UK.
⁷ Clinical Trials Unit, University Hospital Southampton, Southampton, UK.
⁸ Asthma+Lung UK, London, UK.
⁹ Physiotherapy Department, University Hospital Southampton, Southampton, UK.
¹⁰ Centre for Clinical and Community Applications of Health Psychology, University of Southampton, Southampton, UK.

Abstract

Objectives: To describe a transparent approach to planning a digital intervention for adolescents to self-manage their asthma using breathing retraining (BRT), based on an existing, effective adult intervention (BREATHE).

Methods: A theory-, evidence-, and Person-Based Approach was used to maximise the effectiveness and persuasiveness of the intervention. A scoping review and semistructured interviews with target intervention users (N = 18, adolescents aged 12-17 years with asthma and parents) were carried out to explore user perspectives, barriers, and facilitators towards the intended behaviours and potential intervention features. The combined evidence was used alongside and to inform theory-based activities and enabled iterative planning of the intervention.

Results: The scoping review identified themes relating to user-specific self-management issues, content, education, training needs, and features for a digital intervention. Interviews elicited potential barriers to intended behaviours such as the anticipated embarrassment of using BRT and concerns around remaining calm. Facilitators included BRT delivered by adolescents who share experiences of asthma and information for performing exercises discreetly. Relevant theoretical frameworks ensured that appropriate psychological constructs were targeted. A behavioural analysis identified six intervention functions and thirty behaviour change techniques. Logic modelling mapped the programme theory and mechanisms, which aims to improve adolescent asthma-related quality of life.

Conclusions: This study gives a transparent insight into the approach followed to plan a self-guided BRT intervention for adolescents and has led to identification of key behavioural issues, enabling relevant intervention content to be chosen. Insight has been given into adolescent perceptions of BRT, which facilitated development of the prototype intervention.

Keywords: adolescence; asthma; breathing retraining; digital intervention; self-management.

Publication types

Review
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Asthma* / psychology
Asthma* / therapy
Exercise Therapy
Humans
Quality of Life
Self-Management* / methods

Grants and funding

PB‐PG‐0817‐20038/DH_/Department of Health/United Kingdom