Developing web-based Triple P 'Positive parenting programme for families of children with asthma

Abstract

Objectives: This thesis follows a paper-based format and reports a series of papers exploring the development of Triple P Positive Parenting Program with families of children with asthma, for optimising Quality of Life (QOL) and parental confidence with asthma management tasks. A critical evaluation of the research process, which includes a discussion of key findings and implications for future research, is also reported.Method: Paper 1: A systematic review of existing literature concerning the effectiveness of existing psychosocial interventions designed to improve QOL for children with asthma. Paper 2a: An attempt to conduct a pilot RCT into the effectiveness of tailored web-based Triple P for parents of children with asthma aged 2-8 years, for improving parental QOL and confidence with asthma management tasks. Paper 2b: A qualitative investigation of mothers' experiences (n=10) of a separate, NIHR funded, project where an asthma-specific Triple P intervention was delivered face to face. Paper 2b was designed in response to a lack of outcome data in study two. Paper 2b attempts to address an identified need for in-depth qualitative work to understand, more fully, the richness of parents' subjective experiences of parenting interventions and perceived barriers to engagement. Eligible mothers were those who had disengaged from the face to face intervention.Results: Paper 1: Asthma education has dominated the scope of interventions thus far, and highlighted a need for multi-dimensional psychosocial interventions that address asthma education, but also the systemic and family factors that might influence family knowledge and management of asthma. This includes evaluation of the effectiveness of parenting interventions.Paper 2a: Poor engagement, as demonstrated by poor uptake and retention, undermined the effectiveness of the intervention and outcome data was not obtained. Website-usage statistics provided helpful information about potential barriers to engagement with intervention materials and indicated the need for further qualitative work.Paper 2b: Typically, mothers who had disengaged from the intervention did not perceive links between parenting approach and child asthma and behavior. Mothers described wanting more detailed asthma information, greater access to social support and opportunity to discuss idiosyncratic concerns, more case examples of Triple P techniques applied to asthma-specific situations, and help with managing child asthma-related anxious behavior. Conclusions: There is scope for further work to develop parenting interventions for children with asthma. Greater user-involvement in identifying illness-specific issues when planning interventions may lead to wider engagement. Further work is needed to consider ways of presenting acceptable messages about links between asthma, child behavior, and parenting, and to ensure delivery of socially and culturally inclusive interventions that meet the needs of all families likely to benefit.

Date of Award	31 Dec 2013
Original language	English
Awarding Institution	The University of Manchester
Supervisor	Rachel Calam (Supervisor)