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Using the theoretical domains framework to identify barriers and enablers to pediatric asthma management in primary care settings

机译：使用理论域框架识别寄生物和使能器在初级保健环境中对儿科哮喘管理的支持者

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Objectives: This study aimed to apply a theory-based approach to identify barriers and enablers to implementing the Alberta Primary Care Asthma Pediatric Pathway (PCAPP) into clinical practice. Phase 1 included an assessment of assumptions underlying the intervention from the perspectives of the developers. Phase 2 determined the perceived barriers and enablers for: 1) primary care physicians' prescribing practices, 2) allied health care professionals' provision of asthma education to parents, and 3) children and parents' adherence to their treatment plans. Methods: Interviews were conducted with 35 individuals who reside in Alberta, Canada. Phase 1 included three developers. Phase 2 included 11 primary care physicians, 10 allied health care professionals, and 11 parents of children with asthma. Phase 2 interviews were based on the 14 domains of the Theoretical Domains Framework (TDF). Transcribed interviews were analyzed using a directed content analysis. Key assumptions by the developers about the intervention, and beliefs by others about the barriers and enablers of the targeted behaviors were identified. Results: Eight TDF domains mapped onto the assumptions of the pathway as described by the intervention developers. Interviews with health care professionals and parents identified nine TDF domains that influenced the targeted behaviors: knowledge, skills, beliefs about capabilities, social/professional role and identity, beliefs about consequences, environmental context and resources, behavioral regulation, social influences, and emotions. Conclusions: Barriers and enablers perceived by health care professionals and parents that influenced asthma management will inform the optimization of the PCAPP prior to its evaluation.
机译：目的：本研究旨在应用基于理论的方法，以确定将艾伯塔省初级护理哮喘儿科途径（PCAPP）实施临床实践的障碍和使者。第1阶段包括从开发人员的观点介绍干预的假设。第2阶段确定了感知的障碍和推动者：1）初级护理医师的处方实践，2）盟国医疗保健专业人员对父母提供的哮喘教育，3）儿童和父母对其治疗计划的遵守。方法：采访35人居住在加拿大艾伯塔省。第1阶段包括三个开发人员。第2阶段包括11个初级护理医师，10次盟国医疗保健专业人士，11名患有哮喘的11名儿童父母。第2阶段访谈是基于理论域框架（TDF）的14个域名。使用定向内容分析分析转录的访谈。关于开发人员关于干预的关键假设，并确定了其他人关于目标行为的障碍和推动者的信仰。结果：八个TDF域映射到途径的假设，如干预开发人员所述。卫生保健专业人士和父母的访谈确定了九个TDF域，影响了目标行为：知识，技能，关于能力，社会/专业角色和身份的信念，对后果，环境背景和资源，行为监管，社会影响和情绪的信念。结论：受到影响哮喘管理的医疗保健专业人员和父母所感知的障碍和推动者将在评估之前通知PCAPP的优化。

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