1416 Improving health promotion for paediatric respiratory conditions

Abstract

<h3>Aims</h3> To establish current health promotion practice during encounters about respiratory issues To make resources for health promotion that are available and used by medical staff To test the acceptability of the resources to young people and parents. <h3>Methods</h3> Establishing priorities with local public health team. A process map of current health promotion practice. A survey for medical staff to look at current practice and also identify preferred modes of signposting for health information and other services. A survey of parents to establish acceptability of the various modes of signposting. A survey for staff was chosen because there is currently no consistent place where health promotion conversations are documented. Therefore examination of the notes was felt not to be reflective of current practice. All acute consultants, Tier 2 Doctors, Tier 1 Doctors and Nurse practitioners and asthma specialist nurses were asked to complete the survey. <h3>Results</h3> The issues of smoking, indoor air quality and physical exercise were identified as major focus points for children respiratory health promotion • Smoking, Smoking prevalence at 15- 11.2% in County Durham (significantly higher than the England average 8.2%) [1], BTS asthma guidance recommends smoking advice and support stopping[2]. • Indoor air quality. Current concerns about cost of fuel and utility bills. NICE guidance recommends that those with asthma and other respiratory conditions, where housing conditions may be having a negative impact, should have a housing assessment from the local authority[3]. • Physical exercise. Prevalence of healthy weight in County Durham is significantly lower than the England average at both 4-5 and 10-11 years-of-age. Weight management is part of BTS asthma guidance[2]. A process map revealed that: • There was no readily available information on the impact of smoking, indoor pollution and physical activity on respiratory health. • Signposting to smoking cessation services was only encouraged via a leaflet stored in 2 locations • There were no means of referring for a housing assessment or highlighting support for homes. • There were no highlighted avenues for encouraging physical activity. A staff survey Response rate was 71% (24/34 medical staff), the lowest rate for any staff group was 64%. Results showed that although enquiring about smoking was frequent, discussions about stop smoking services, indoor air quality and exercise were infrequent and inconsistently carried out across the medical team (figure 1). Staff were less likely to discuss sudden infant death and lung function when discussing the dangers of smoking. Staff highlighted that there were a large range of preferred means to access information. Particular gaps include resources on the trust intranet page for paediatrics, QR codes and search terms. A survey of parents preferred means of receiving information and details about signposted services is being carried out late February 2022. <h3>Conclusion</h3> The discussion with public health, process mapping and survey prompted a number of interventions: • A teaching session • Development of information summaries for each topic. • QR codes and search terms for relevant websites and telephones. • A referral form for local authority housing issue support. • Health promotion documentation. There will be a repeated measure of practice in April 2022.