Laird PJ

Walker R

McCallum G

Toombs M

Barwick M

Morris, Peter

Aitken R

Cooper M

Norman R

Patel, Bhavini

Lau G

Chang AB

Schultz A

2022-12-29

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.

Wal-yan Respiratory Research Centre, Telethon Kids Institute, Perth, WA, Australia.

Perth Children's Hospital, Perth, WA, Australia.

Division of Paediatrics, Faculty of Medicine, University of Western Australia, Perth, Australia.

School of Indigenous Studies, Poche Centre for Indigenous Health, University of Western Australia, Perth, WA, Australia.

School of Population Health, University of Western Australia, Perth, WA, Australia.

Ngangk Yira Institute for Change, Murdoch University, Perth Western, Australia.

Child Health Division Menzies School of Health Research, Charles Darwin University, NT, Darwin, Australia.

Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia.

Hospital for Sick Children, Toronto, Canada.

Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.

College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia.

Charles Darwin University College of Indigenous Future, Arts & Society, Darwin, NT, Australia.

School of Population Health, Curtin University, Perth, WA, Australia.

Northern Territory Department of Health, Darwin, NT, Australia.

Department of Respiratory Medicine, Queensland Children's Hospital, Brisbane, QLD, Australia.

Australian Centre For Health Services Innovation, Qld University of Technology, Brisbane, QLD, Australia.

Wal-yan Respiratory Research Centre, Telethon Kids Institute, Perth, WA, Australia. Andre.Schultz@health.wa.gov.au.

Perth Children's Hospital, Perth, WA, Australia. Andre.Schultz@health.wa.gov.au.

Division of Paediatrics, Faculty of Medicine, University of Western Australia, Perth, Australia. Andre.Schultz@health.wa.gov.au.

BMC Pulm Med. 2022 Dec 29;22(1):492. doi: 10.1186/s12890-022-02219-0.

0000-0002-2000-8910

https://pubmed.ncbi.nlm.nih.gov/36581812/?otool=iaurydwlib

https://hdl.handle.net/10137/12362

22

Child

Humans

Cough/diagnosis

Quality of Life

*Bronchitis/diagnosis

Implementation Science

Australia

Chronic Disease

*Bacterial Infections/diagnosis

*Bronchiectasis/complications

*Bronchitis, Chronic/complications

Outcome Assessment, Health Care

Multicenter Studies as Topic

Change in health outcomes for First Nations children with chronic wet cough: rationale and study protocol for a multi-centre implementation science study.

Journal Article

Publication