Browsing by Author "Bird, D."
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Item Metadata only Development of tailored and integrated health-care interventions to reduce inequalities in health outcomes(Elsevier, 2013) Lakhanpaul, M.; Bird, D.; Culley, Lorraine; Hudson, Nicky; Robertson, N.; Johal, Narynder; McFeeters, Melanie; Williams, Charlotte; Johnson, Mark, 1948 Mar. 16-Item Metadata only Patient centred care: involving parents/carers and children in developing healthcare interventions(2012-10) Culley, Lorraine; Lakhanpaul, M.; Bird, D.; Hudson, Nicky; Johnson, M.Item Metadata only Patient Centred Care: Involving Parents/Carers and Children in Developing Healthcare Interventions(University of Alberta, 2012) Culley, Lorraine; Lakhanpaul, M.; Bird, D.; Hudson, Nicky; Johnson, Mark, 1948 Mar. 16-Item Metadata only Qualitative study to identify ethnicity-specific perceptions of and barriers to asthma management in South Asian and White British children with asthma(BMJ, 2019-02-08) Lakhanpaul, M.; Culley, Lorraine; Huq, T.; Robertson, N.; McFeeters, Melanie; Manikam, L.; Johal, N.; Hamlyn-Williams, C.; Hudson, Nicky; Bird, D.; Johnson, M.R.D.Objective This 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. Setting South Asian and White British children with asthma took part in semi-structured interviews in Leicester, UK. Participants Thirty three South Asian and 14 White British children with asthma and aged 5–12 years were interviewed. Results Both 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. Conclusions The 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. This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made.Item Metadata only A qualitative study to identify parents’ perceptions of and barriers to asthma management in children from South Asian and White British families(BioMed Central, 2017-09-20) Lakhanpaul, M.; Culley, Lorraine; Robertson, N.; Bird, D.; Hudson, Nicky; Johal, Narynder; McFeeters, Melanie; Angell, Emma; Hamlyn-Williams, Charlotte; Abbas, Nadine; Manikam, L.; Johnson, Mark, 1948 Mar. 16-Background Over one million children receive treatment for asthma in the UK. South Asian children experience excess morbidity and higher rates of hospitalization than the White population. This study aimed to explore perceptions and experiences of asthma and asthma management in British South Asian and White British families, to identify barriers to optimal management and to inform culturally appropriate interventions to improve management. Methods A qualitative methodology, using semi-structured interviews was adopted. Members of 30 families from six major South Asian ethnic-religious groups were purposively sampled (n = 49). For comparison, 17 White British parents were interviewed. Topics included understandings of asthma; day-to-day management; interactions with health care providers and the perceived quality of healthcare services. Data were analyzed using interpretive thematic analysis, facilitated by NVivo. Similarities and differences between South Asian and White families were analysed across key themes. Results Many of the problems facing families of a child with asthma were common to South Asian and White British families. Both had limited understanding of asthma causes and triggers and expressed confusion about the use of medications. Both groups reported delays in receiving a clear diagnosis and many experienced what was perceived as uncoordinated care and inconsistent advice from health professionals. No family had received an asthma plan. South Asian families had more difficulty in recognising severity of symptoms and those with limited English faced additional barriers to receiving adequate information and advice about management due to poor communication support systems. South Asian parents reported higher levels of involvement of wider family and higher levels of stigma. Attendance at the emergency department was related to previous experience, difficulties in accessing primary care, lack of knowledge of alternatives and difficulties in assessing severity. Conclusions Barriers to optimal asthma management exist at the individual family, community and healthcare systems levels. Culturally sensitive, holistic and collaboratively designed interventions are needed. Improved communication support for families with lower proficiency in English is required. Healthcare professionals need to ensure that families receive an asthma plan and make greater efforts to check families’ understandings of asthma triggers, use of medications, assessment of asthma severity and accessing help.Item Open Access 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(BMC, 2020-10) Lakhanpaul, M.; Culley, Lorraine; Robertson, N.; Alexander, E.; Bird, D.; Hudson, Nicky; Johal, N.; McFeeters, M.; Hamlyn-Williams, C.; Manikam, L.; Boo, Y.; Lakhanpaul, M.; Johnson, M.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: 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.Item Metadata only A systematic review of explanatory factors of barriers and facilitators to improving asthma management in South Asian children(BioMed Central, 2014) Lakhanpaul, M.; Bird, D.; Manikam, L.; Culley, Lorraine; Perkins, G.; Hudson, Nicky; Wilson, J.; Johnson, M.Item Metadata only Why collaborate with children in health research: an analysis of the risks and benefits of collaboration with children(2012) Bird, D.; Culley, Lorraine; Lakhanpaul, M.Involvement of service users in decision making, in both clinical and research settings, has become a central feature of many health and research funding policies in the last 15 years. Over the same timeframe, there has been an increasing focus on children's rights, promoted by the UN Convention of the Rights of the Child, which gives children a right to be involved in decisions that affect their lives. In a research setting, this has resulted in increased engagement of children in research, as opposed to relying on parents or carers to represent their children, and a shift from research on children to research with children. In this article, we discuss collaboration with children under the age of 16 years in health research: what this means and why (or why not) to do it. The definition of collaboration is discussed and the lines among collaboration, involvement, participation and participatory research considered. The risks and benefits of collaboration are reviewed, both theoretical and evidence based, where evidence exists. The review ends with a look towards the future including the need for agreed definitions, better reporting of collaboration and other patient and public involvement activities with children to build up the much needed evidence base, the need for cost–benefit evaluations and, most importantly, the need for careful consideration as to whether collaborating with children is appropriate in each circumstance.