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

• Published in: BMC Pulmonary Medicine
• Main Authors: Laird PJ, Walker R, McCallum G, Toombs M, Barwick M, Morris P, Aitken R, Cooper M, Norman R, Patel B, Lau G, Chang AB, Schultz A
• Format: Article in Journal/Newspaper
• Language: English
• Published: England 2022
• Subjects: 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; First Nations
• Online Access: https://hdl.handle.net/10137/12362; https://doi.org/10.1186/s12890-022-02219-0; https://www.ezpdhcs.nt.gov.au/login?url=https://www.ncbi.nlm.nih.gov/pubmed/36581812

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 ...