TY - JOUR
T1 - Change in health outcomes for First Nations children with chronic wet cough
T2 - Rationale and study protocol for a multi-centre implementation science study
AU - Laird, Pamela J
AU - Walker, Roz
AU - McCallum, Gabrielle
AU - Toombs, Maree
AU - Barwick, Melanie
AU - Morris, Peter
AU - Aitken, Robyn
AU - Cooper, Matthew
AU - Norman, Richard
AU - Patel, Bhavini
AU - Lau, Gloria
AU - Chang, Anne B
AU - Schultz, André
PY - 2022/12
Y1 - 2022/12
N2 - Background: In children, chronic wet cough may be a sign of underlying lung disease, including protracted bacterial bronchitis (PBB) and bronchiectasis. Chronic (> 4 weeks in duration) wet cough (without indicators pointing to alternative causes) that responds to antibiotic treatment is diagnostic of PBB. Timely recognition and management of PBB can prevent disease progression to irreversible bronchiectasis with lifelong consequences. However, detection and management require timely health-seeking by carers and effective management by clinicians. We aim to improve (a) carer health-seeking for chronic wet cough in their child and (b) management of chronic wet cough in children by clinicians. We hypothesise that implementing a culturally integrated program, which is informed by barriers and facilitators identified by carers and health practitioners, will result in improved lung health of First Nations children, and in the future, a reduced the burden of bronchiectasis through the prevention of the progression of protracted bacterial bronchitis to bronchiectasis. Methods: This study is a multi-centre, pseudorandomised, stepped wedge design. The intervention is the implementation of a program. The program has two components: a knowledge dissemination component and an implementation component. The implementation is adapted to each study site using a combined Aboriginal Participatory Action Research and an Implementation Science approach, guided by the Consolidated Framework of Implementation Research. There are three categories of outcome measures related to (i) health (ii) cost, and (iii) implementation. We will measure health-seeking as the proportion of parents seeking help for their child in a 6-month period before the intervention and the same 6-month period (i.e., the same six calendar months) thereafter. The parent-proxy, Cough-specific Quality of Life (PC-QoL) will be the primary health-related outcome measure. Discussion: We hypothesise that a tailored intervention at each site will result in improved health-seeking for carers of children with a chronic wet cough and improved clinician management of chronic wet cough. In addition, we expect this will result in improved lung health outcomes for children with a chronic wet cough. Trial registration: Australian New Zealand Clinical Trials Registry; ACTRN12622000430730, registered 16 March 2022, Retrospectively registered.
AB - Background: In children, chronic wet cough may be a sign of underlying lung disease, including protracted bacterial bronchitis (PBB) and bronchiectasis. Chronic (> 4 weeks in duration) wet cough (without indicators pointing to alternative causes) that responds to antibiotic treatment is diagnostic of PBB. Timely recognition and management of PBB can prevent disease progression to irreversible bronchiectasis with lifelong consequences. However, detection and management require timely health-seeking by carers and effective management by clinicians. We aim to improve (a) carer health-seeking for chronic wet cough in their child and (b) management of chronic wet cough in children by clinicians. We hypothesise that implementing a culturally integrated program, which is informed by barriers and facilitators identified by carers and health practitioners, will result in improved lung health of First Nations children, and in the future, a reduced the burden of bronchiectasis through the prevention of the progression of protracted bacterial bronchitis to bronchiectasis. Methods: This study is a multi-centre, pseudorandomised, stepped wedge design. The intervention is the implementation of a program. The program has two components: a knowledge dissemination component and an implementation component. The implementation is adapted to each study site using a combined Aboriginal Participatory Action Research and an Implementation Science approach, guided by the Consolidated Framework of Implementation Research. There are three categories of outcome measures related to (i) health (ii) cost, and (iii) implementation. We will measure health-seeking as the proportion of parents seeking help for their child in a 6-month period before the intervention and the same 6-month period (i.e., the same six calendar months) thereafter. The parent-proxy, Cough-specific Quality of Life (PC-QoL) will be the primary health-related outcome measure. Discussion: We hypothesise that a tailored intervention at each site will result in improved health-seeking for carers of children with a chronic wet cough and improved clinician management of chronic wet cough. In addition, we expect this will result in improved lung health outcomes for children with a chronic wet cough. Trial registration: Australian New Zealand Clinical Trials Registry; ACTRN12622000430730, registered 16 March 2022, Retrospectively registered.
KW - Chronic wet cough
KW - First Nations children
KW - Knowledge Translation
KW - Protracted bacterial bronchitis
UR - http://www.scopus.com/inward/record.url?scp=85145132979&partnerID=8YFLogxK
UR - http://purl.org/au-research/grants/NHMRC/1170735
UR - http://purl.org/au-research/grants/NHMRC/1058213
UR - http://purl.org/au-research/grants/NHMRC/1040830
UR - http://purl.org/au-research/grants/NHMRC/1170958
U2 - 10.1186/s12890-022-02219-0
DO - 10.1186/s12890-022-02219-0
M3 - Article
C2 - 36581812
AN - SCOPUS:85145132979
SN - 1471-2466
VL - 22
JO - BMC Pulmonary Medicine
JF - BMC Pulmonary Medicine
IS - 1
M1 - 492
ER -