Examining barriers and facilitators in asthma inhaler technique education and technology-enhanced educational tools in children: A mixed methods evaluation using the theoretical domains framework.

Abstract

Educational interventions for asthma inhaler technique have been identified as successful in improving technique in children, yet inhaler technique has not improved over time. New approaches should be considered, including the use of technology-based interventions such as smartphone and tablet applications. Adoption and implementation of such technology in healthcare has been historically slow. This mixed-methods study aimed to identify the barriers and facilitators of delivering and receiving asthma inhaler education for children in a hospital setting, including technology-based interventions. Children with asthma, their caregivers, and healthcare professionals who regularly provide asthma education, were invited to participate in a qualitative interview and brief questionnaire to describe their experiences, knowledge, beliefs, and recommendations about asthma education delivery. The Theoretical Domains Framework was used to develop questions for the semistructured moderator guide, questionnaire, and provide the rigorous evaluation framework for deductive thematic analysis. Sixteen interviews and questionnaires were conducted with participants. Overall, healthcare professionals perceived more barriers in asthma inhaler education delivery than asthmatic children and their caregivers to receiving the education. Healthcare professionals and caregivers identified time-pressures within a hospital setting as a barrier for providing sufficient education. However, all participants felt they had adequate knowledge in their asthma management skills and inhaler technique. Technology-based innovations were viewed positively by all participant groups to improve asthma education. Several barriers and facilitators to current hospital-based asthma education delivery were reported by target end-users. Future programs should consider these findings when developing asthma inhaler educational interventions, particularly those using technology-enhanced information delivery.