Qualitative study to identify ethnicity-specific perceptions of and barriers to asthma management in South Asian and White British children with asthma

ObjectiveThis paper draws on the data from the Management and Interventions for Asthma (MIA) study to explore the perceptions and experiences of asthma in British South Asian children using semi-structured interviews. A comparable cohort of White British children was recruited to identify whether any emerging themes were subject to variation between the two groups so that generic and ethnicity-specific themes could be identified for future tailored intervention programmes for South Asian children with asthma.SettingSouth Asian and White British children with asthma took part in semi-structured interviews in Leicester, UK.ParticipantsThirty three South Asian and 14 White British children with asthma and aged 5–12 years were interviewed.ResultsBoth similar and contrasting themes emerged from the semi-structured interviews. Interviews revealed considerable similarities in the experience of asthma between the South Asian and White British children, including the lack of understanding of asthma (often confusing trigger with cause), lack of holistic discussions with healthcare professionals (HCPs), an overall neutral or positive experience of interactions with HCPs, the role of the family in children’s self-management and the positive role of school and friends. Issues pertinent to South Asian children related to a higher likelihood of feeling embarrassed and attributing physical activity to being a trigger for asthma symptoms.ConclusionsThe two ethnicity-specific factors revealed by the interviews are significant in children’s self-management of asthma and therefore, indicate the need for a tailored intervention in South Asian children.

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Objectively-measured sedentary time and physical activity in a bi-ethnic sample of young children: variation by socio-demographic, temporal and perinatal factors

10.21203/rs.2.18426/v2 ◽

2020 ◽

Author(s):

Paul Collings ◽

Sufyan A Dogra ◽

Silvia Costa ◽

Daniel D Bingham ◽

Sally E. Barber

Keyword(s):

Physical Activity ◽

Young Children ◽

South Asian ◽

Sedentary Time ◽

Activity Levels ◽

Light Physical Activity ◽

Asian Children ◽

Physical Activity Levels ◽

Vector Magnitude ◽

British Children

Abstract Background: Evidence suggests that South Asian school-aged children and adults are less active compared to the white British population. It is unknown if this generalises to young children. We aimed to describe variability in levels of physical activity and sedentary time in a bi-ethnic sample of young children from a deprived location. Methods: This observational study included 202 South Asian and 140 white British children aged 1.5 to 5y, who provided 3,181 valid days of triaxial accelerometry (Actigraph GT3X+). Variability in sedentary time and physical activity levels were analysed by linear multilevel modelling. Logistic multilevel regression was used to identify factors associated with physical inactivity (failing to perform ≥180 minutes of total physical activity including ≥60 minutes moderate-to-vigorous physical activity (MVPA) per day). Results: There were no significant ethnic differences in the overall levels of behaviours; South Asian and white British children spent half of daily time sedentary, just over 40% in light physical activity, and the remaining 7.5 to 8% of time in MVPA. Sedentary time was lower and physical activity levels were higher in older children, and levels of MVPA and vector magnitude counts per minute (CPM) were higher on weekends compared to weekdays. In South Asian children, sedentary time was lower on weekends. Sedentary time was lower and physical activity levels were higher in spring compared to winter in white British children, and in all seasons compared to winter in South Asian children. South Asian children born at high birth weight performed more MVPA, and in both ethnicities there was some evidence that children with older mothers were more sedentary and less active. Sedentary time was higher and light physical activity was lower in South Asian children in the highest compared to the lowest income families. South Asian girls performed less MVPA, registered fewer vector magnitude CPM, and were 3.5 times more likely to be physically inactive than South Asian boys. Conclusions: Sedentary time and physical activity levels vary by socio-demographic, temporal and perinatal characteristics in young children from a deprived location. South Asian girls have the most to gain from efforts to increase physical activity levels.

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Adolescent feedback on predisposing, reinforcing and enabling features in asthma self-management apps

Health Education Journal ◽

10.1177/0017896919836693 ◽

2019 ◽

Vol 78 (7) ◽

pp. 770-783

Author(s):

Courtney A Roberts ◽

Adam J Sage ◽

Lorie L Geryk ◽

Betsy L Sleath ◽

Delesha M Carpenter

Keyword(s):

Peak Flow ◽

Asthma Management ◽

Persistent Asthma ◽

Health Behaviours ◽

Self Management ◽

Structured Interviews ◽

Positive Health ◽

Telephone Interviews ◽

Qualitative Interview Study ◽

Mobile Health Apps

Objective:Mobile health apps hold potential to support and reinforce positive health behaviours, especially among young people with chronic diseases like asthma that require continual self-management. We aimed to gain feedback from adolescents with asthma on two existing asthma self-management apps to guide the development of an evidence- and theory-based asthma app that meets their asthma management needs.Design:A qualitative interview study was conducted with adolescents with persistent asthma ( n = 20), aged 12–16.Setting:Interviews took place after the individual’s clinic appointment and during telephone interviews one week later.Methods:Participants provided feedback on two asthma self-management apps during two semi-structured interviews. Interviews were audio-recorded, transcribed verbatim and analysed thematically using MAXQDA 11. The Precede–Proceed Model (PPM) was used as a framework to evaluate perceptions of app features, including utility. Suggestions for improvements, including addition of predisposing, reinforcing and enabling PPM features, were identified.Results:The majority of app features functioned as enabling (e.g. inputting triggers, recording doctor’s appointments and tracking peak flow). However, participants recommended addition of predisposing and reinforcing features, including knowledge on dealing with asthma triggers (predisposing) and a reward system for daily peak flow entry (reinforcing), to support their asthma management.Conclusion:Findings suggest that including predisposing, reinforcing and enabling features in asthma apps could facilitate asthma self-management. Public health professionals should partner with app developers in the development of asthma self-management apps that include predisposing, reinforcing and enabling features to meet user needs and ensure they are effective and accepted behaviour change apps.

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Asthma Management: Part I: An Overview of the Problem and Current Trends

The Journal of School Nursing ◽

10.1177/10598405020180030201 ◽

2002 ◽

Vol 18 (3) ◽

pp. 128-137 ◽

Cited By ~ 7

Author(s):

Valerie O’Toole Baker ◽

Janet Friedman ◽

Rita Schmitt

Keyword(s):

Asthma Management ◽

Primary Care Providers ◽

School Nurse ◽

Normal Lung ◽

Complementary Alternative Medicine ◽

Care Providers ◽

Current Trends ◽

Management Plans ◽

Children With Asthma

Death rates from asthma have increased or remained stable over the past decade despite increased knowledge about the pathophysiology and improved treatment of the disease, a fact that is both puzzling and disconcerting. Some children with asthma experience severe and life-interfering exacerbations separated by long periods of normal lung function and no symptoms. Asthma management plans are developed by primary care providers and the family. School nurses implement and monitor the child’s response to the plan. Therefore, the school nurse needs current information about asthma management. Part I of this two-part series describes the pathophysiology of asthma and the types, risk factors, and current trends in management of the disease. The role of the school nurse in asthma management is outlined, including how he or she can influence environmental factors that precipitate asthma symptoms or exacerbations. Part II will discuss the role of the school nurse in pharmacologic management of asthma. Complementary alternative medicine for asthma management will be described, as well as health teaching for the child with asthma and their family.

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Objectively-measured sedentary time and physical activity in a bi-ethnic sample of young children: variation by socio-demographic, temporal and perinatal factors

10.21203/rs.2.18426/v1 ◽

2019 ◽

Author(s):

Paul Collings ◽

Sufyan A Dogra ◽

Silvia Costa ◽

Daniel D Bingham ◽

Sally E. Barber

Keyword(s):

Physical Activity ◽

Young Children ◽

South Asian ◽

Sedentary Time ◽

Activity Levels ◽

Light Physical Activity ◽

Asian Children ◽

Physical Activity Levels ◽

Vector Magnitude ◽

British Children

Abstract Background: Evidence suggests that South Asian school-aged children and adults are less active compared to the white British population. It is unknown if this generalises to young children. We aimed to describe variability in levels of physical activity and sedentary time in a bi-ethnic sample of young children from a deprived location.Methods: This observational study included 202 South Asian and 140 white British children aged 1.5 to 5y, who provided 3,181 valid days of triaxial accelerometry. Variability in sedentary time and physical activity levels were analysed by linear multilevel modelling. Logistic multilevel regression was used to identify factors associated with physical inactivity (failing to perform ≥180 minutes of total physical activity including ≥60 minutes moderate-to-vigorous physical activity (MVPA) per day).Results: There were no significant ethnic differences in the overall levels of behaviours; South Asian and white British children spent half of their daily time sedentary, just over 40% in light physical activity, and the remaining 7.5 to 8% of time in MVPA. Sedentary time was lower and physical activity levels were higher in older children, and levels of MVPA and vector magnitude counts per minute (CPM) were higher at weekends compared to weekdays. In South Asian children, sedentary time was lower at weekends. Sedentary time was lower and physical activity levels were higher in spring compared to winter in white British children, and in all seasons compared to winter in South Asian children. South Asian children born at high birth weight performed more MVPA, and in both ethnicities there was some evidence that children with older mothers were more sedentary and less active. Sedentary time was higher and light physical activity was lower in South Asian children in the highest compared to the lowest income families. South Asian girls performed less MVPA, registered fewer vector magnitude CPM, and were 3.5 times more likely to be physically inactive than South Asian boys.Conclusions: Sedentary time and physical activity levels vary by socio-demographic, temporal and perinatal characteristics in young children from a deprived location. South Asian girls have the most to gain from efforts to increase physical activity levels.

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Pharmacometabolomics of Bronchodilator Response in Asthma and the Role of Age-Metabolite Interactions

Metabolites ◽

10.3390/metabo9090179 ◽

2019 ◽

Vol 9 (9) ◽

pp. 179 ◽

Cited By ~ 1

Author(s):

Rachel S. Kelly ◽

Joanne E. Sordillo ◽

Sharon M. Lutz ◽

Lydiana Avila ◽

Manuel Soto-Quiros ◽

...

Keyword(s):

Asthma Management ◽

Management Program ◽

P Value ◽

Bronchodilator Response ◽

Age Related ◽

Children With Asthma ◽

The Mean ◽

Interaction With Age ◽

Effect Of Age

The role of metabolism in modifying age-related differential responses to asthma medications is insufficiently understood. The objective of this study was to determine the role of the metabolome in modifying the effect of age on bronchodilator response (BDR) in individuals with asthma. We used longitudinal measures of BDR and plasma metabolomic profiling in 565 children with asthma from the Childhood Asthma Management Program (CAMP) to identify age by metabolite interactions on BDR. The mean ages at the three studied time-points across 16 years of follow-up in CAMP were 8.8, 12.8, and 16.8 years; the mean BDRs were 11%, 9% and 8%, respectively. Of 501 identified metabolites, 39 (7.8%) demonstrated a significant interaction with age on BDR (p-value < 0.05). We were able to validate two significant interactions in 320 children with asthma from the Genetics of Asthma in Costa Rica Study; 2-hydroxyglutarate, a compound involved in butanoate metabolism (interaction; CAMP: β = −0.004, p = 1.8 × 10−4; GACRS: β = −0.015, p = 0.018), and a cholesterol ester; CE C18:1 (CAMP: β = 0.005, p = 0.006; GACRS: β = 0.023, p = 0.041) Five additional metabolites had a p-value < 0.1 in GACRS, including Gammaminobutyric acid (GABA), C16:0 CE, C20:4 CE, C18.0 CE and ribothymidine. These findings suggest Cholesterol esters and GABA may modify the estimated effect of age on bronchodilator response.

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When Control Exacerbates Distress: A Qualitative Study Exploring the Experiences of Hong Kong Chinese Parents in Caring for a Child with Asthma

10.20944/preprints201805.0304.v1 ◽

2018 ◽

Author(s):

Yuen-yu Chong ◽

Doris Leung ◽

Yim-wah Mak

Keyword(s):

Hong Kong ◽

Childhood Asthma ◽

Asthma Management ◽

Structured Interviews ◽

Educational Training ◽

Chinese Parents ◽

Children With Asthma ◽

Qualitative Descriptive ◽

Conventional Content Analysis ◽

Primary Form

Many parents have difficulty managing childhood asthma. In Hong Kong (HK), while medication is the primary form of treatment, traditional Chinese medicine is another favored option. In addition, HK follows a dual-track healthcare system, which may pose unique experiences for Chinese parents in childhood asthma management. This qualitative descriptive study aimed to explore the experiences of HK Chinese parents in caring for their children with asthma. Methods: Fourteen HK Chinese mothers of children (aged 3-10) suffering from asthma were purposively sampled to participate in individual, semi-structured interviews. A realist approach following conventional content analysis was used to interpret the interviews. Results: The mothers expressed feelings of uncertainty, fear of asthma crises, and searching for ways to cope. These feelings triggered various strategies to control their child’s asthma. As long as the child’s asthma symptoms recurred, the mothers’ distress continued. Their distress was sometimes exacerbated by self-doubt and worries about whether they would receive adequate support from their family and healthcare professionals. Conclusion: Helping parents to understand their limits may help them be more open to varied aspects of their caregiving experiences, and thus to cope better. Psychological interventions together traditional educational training may help to alleviate parents’ psychological difficulties.

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Acceptability of Serious Games in Pediatric Asthma Education and Self-Management: Qualitative study with a consensual qualitative design (Preprint)

10.2196/preprints.33389 ◽

2021 ◽

Author(s):

Nicole Silva-Lavigne ◽

Alena Valderrama ◽

Sandra Pelaez ◽

Myriam Bransi ◽

Fabio Balli ◽

...

Keyword(s):

Qualitative Study ◽

Focus Groups ◽

Support System ◽

Serious Games ◽

Self Management ◽

Asthma Education ◽

Asthma Knowledge ◽

Children With Asthma ◽

The Impact

BACKGROUND Asthma is the most common chronic pediatric disease. Despite existing tools to manage asthma, 40-55% of children with asthma suffer from uncontrolled asthma. Serious games (SGs) represent a novel approach in promoting asthma education and self-management for children. OBJECTIVE In this qualitative study with an embedded quantitative design, we used focus groups and questionnaires to describe the perceived role of SGs in different aspects of asthma self-management by children and their parents. These aspects include asthma perception and knowledge, the impact of asthma and barriers to asthma self-management, and the support system for asthma self-management. METHODS Five children with asthma and their parents were invited to participate during an organized gaming session. Children and their parents filled out a pre-gaming questionnaire on their medical history and asthma knowledge. They were then invited to test four original SGs prototypes, after which the children answered a post-gaming questionnaire on their asthma knowledge and perception of the SGs. Children and their parents subsequently participated in parallel focus groups which were video- and/or audio-recorded, transcribed verbatim, and analyzed by reaching consensus among members of the research team. RESULTS The mean age of the children was 10.3 year, with 20% being male. Qualitative data from the transcripts were coded into three separate domains: 1) asthma self-management perception and knowledge, 2) impact of asthma and barriers to asthma self-management, and 3) support system for asthma self-management. We specifically explored the perceived roles of SGs within each of these domains. A key takeaway message was identified for each of these three domains: 1) Heterogeneity of asthma knowledge and the ability of SGs to encourage knowledge transfer through games, 2) Consequences and limitations of asthma and the ability of SGs to allow for identification and management of real-life situations through games, and 3) Insufficient support system and the ability of SGs to encourage playing with others for support and shared knowledge. CONCLUSIONS Our study explored the role of SGs in the self-management of asthma as perceived by children and their parents. Our findings support the acceptability of SGs in asthma education and self-management in pediatrics and the necessity for future development in this field.

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Asthma Management, Part II: Pharmacologic Management

The Journal of School Nursing ◽

10.1177/10598405020180050501 ◽

2002 ◽

Vol 18 (5) ◽

pp. 257-269 ◽

Cited By ~ 4

Author(s):

Valerie O’Toole Baker ◽

Janet Friedman ◽

Rita Schmitt

Keyword(s):

School Setting ◽

Asthma Management ◽

School Nurse ◽

Management Plan ◽

School Nursing ◽

Pharmacologic Therapy ◽

Children With Asthma ◽

Pharmacologic Management ◽

School Team

Part I of this two-part series described the pathophysiology, types, and risk factors associated with asthma. The role of the school nurse in the development, implementation, and evaluation of a comprehensive asthma management plan was outlined, as was the role of the school nurse in controlling factors that precipitate asthma symptoms or exacerbations. Part II reviews specific school nursing responsibilities associated with current pharmacologic therapy for the child with asthma. Issues related to nutritional supplements as well as complementary and alternative treatments used in asthma management are covered. Other topics discussed include issues related to access of asthma medication in the school setting by the student, involvement of the school team in the care of the child with asthma, and health education strategies for children with asthma and their families.

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Harmless flirtations or co-creation? Exploring flirtatious encounters in hospitable experiences

Tourism and Hospitality Research ◽

10.1177/14673584211049297 ◽

2021 ◽

Vol 21 (4) ◽

pp. 473-486

Author(s):

Darryl Gibbs ◽

Clare Haven-Tang ◽

Caroline Ritchie

Keyword(s):

Close Contact ◽

Positive Influence ◽

Service Work ◽

Structured Interviews ◽

Positive Role ◽

Complex Issue ◽

Service Staff ◽

And Performance ◽

The Relationship

Exploring the relationship between sexual harassment and service work in hospitality has long been considered a complex issue, due to the blurred and sometimes invisible line between flirting, harassment and the very nature of close contact hospitality service work. Little research has examined how mutual flirtations (when they are conducted in an appropriate manner and within safe boundaries) between customer and staff can play a positive role in the co-creation of hospitable experiences. This paper presents the findings of one theme from a wider PhD study which sought to explore the role of staff, customers and managers in the co-creation and performance of natural hospitable experiences. The focus of this paper is an exploration of the relationship between flirtatious encounters and the co-creation of hospitable experiences. In the wider study, three research phases were conducted. Semi-structured interviews were undertaken with service staff and managers from a range of hospitality servicescapes and data was gathered from customers through a number of focus groups, and the findings suggest that harmless and appropriate flirtatious encounters between customers and staff which are initiated in a natural and safe manner can have a positive influence on the co-creation of hospitable experiences.

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