A structured collaborative approach to intervention design using a modified intervention mapping approach: a case study using the Management and Interventions for Asthma (MIA) project for South Asian children

Abstract

Background 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. Methods 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. Results 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. Conclusions 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.

South Asian immigrants’ and their family carers’ beliefs, practices and experiences of childhood long‐term conditions: An integrative review

“…These hospitalizations are often identified as potentially preventable. Similar ethnic disparities in asthma outcomes have also been noted in the USA, New Zealand and Canada (Benchimol et al, 2015;Lakhanpaul et al, 2020;Mehrotra et al, 2014;Mehta, 2012).…”

Developing a realist informed framework for cultural adaptation of lifestyle interventions for the prevention of type 2 diabetes in South Asian populations in Europe

“…Focusing on South Asian populations in Europe and lifestyle interventions, we only identified eight core studies and, consequently, were only able to explore one domain of the typology of adaptation. Further exploration to shed light on the mechanisms of cultural adaptation, including the examination of theoretical approaches from other populations and other chronic health conditions, for example, asthma, 48 is imperative and our work provides a good framework to base this on. For example, social cultural stress is likely to be contributed to by people's experience of both institutional and interpersonal racism that will impact significantly on their health and their capacity to engage with lifestyle interventions, 49 and this is an area warranting further exploration.…”

Key considerations when involving children in health intervention design: reflections on working in partnership with South Asian children in the UK on a tailored Management and Intervention for Asthma (MIA) study

“…With this in mind, the MIA study aimed to develop an intervention-planning framework for South Asian children with asthma in the UK by using a tailored collaborative participatory method [ 32 – 35 ]. The study comprised of four iterative phases designed to explore the beliefs and perceptions of individuals, families, and communities: (1) a systematic evidence synthesis; (2) a community study; (3) a families and healthcare professionals’ study; (4) the development of potential collaborative intervention strategies [ 32 ]. These were used as part of a modified form of intervention mapping, i.e., a planning framework grounded in CBPR that describes an tailored systematic process for intervention development, implementation and evaluation [ 36 ].…”

“…Several approaches were used to encourage children to participate in the study and feel involved and heard during the research process. The children’s interviews explored their experiences of managing their asthma (Additional file 1 : Annex 1: Topic Guide), while the prioritisation workshop saw children ranking the perceived importance of different aspects of their care [ 32 , 34 ].…”

“…During Phase 4 this was mitigated by conducting the parents’ focus groups at the same time as the children’s prioritisation workshop [ 32 , 35 ]. By conducting both sessions in the same hall simultaneously, we allowed for both sides to answer free from judgement whilst minimising the stress of being separated from each other.…”