Evidence map›Paper›PMID 37591653›Full record

ArticleBMJ open2023

Barriers to and facilitators of a just-in-time adaptive intervention for respiratory illness in cerebral palsy: a qualitative study.

Kristina Devi Singh-Verdeflor, Heidi M Kloster, Carlos Lerner, Thomas S Klitzner, Christopher C Cushing, Danielle M Gerber, Barbara J Katz, Paul J Chung, Roxana Delgado-Martinez, Lorena Porras-Javier and 5 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.9field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 3 citations in OpenAlex.

  1. Trial
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 5 institutions in 1 country.

Kristina Devi Singh-VerdeflorPediatrics, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, USA ksinghverdef@wisc.edu.ORCID 0009-0003-0689-7197
Heidi M KlosterPediatrics, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, USA.
Carlos LernerPediatrics, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, USA.
Thomas S KlitznerPediatrics, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, USA.
Christopher C CushingClinical Child Psychology Program and Schiefelbusch Life Span Institute, University of Kansas, Lawrence, Kansas, USA.
Danielle M GerberPediatrics, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, USA.
Barbara J KatzFamily Voices of Wisconsin, Madison, Wisconsin, USA.
Paul J ChungHealth Systems Science, Kaiser Permanente Bernard J Tyson School of Medicine, Pasadena, California, USA.
Roxana Delgado-MartinezPediatrics, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, USA.
Lorena Porras-JavierPediatrics, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, USA.
Siem IaPediatrics, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, USA.
Teresa WagnerPediatrics, UW Health American Family Children's Hospital, Madison, Wisconsin, USA.
Mary L EhlenbachPediatrics, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, USA.
Gemma WarnerPediatrics, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, USA.
Ryan J CollerPediatrics, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, USA.
University of Wisconsin–Madison · USUniversity of California, Los Angeles · USKaiser Permanente · USUniversity of Kansas · USUniversity of Wisconsin Health · US

Funding

RE-PACT: Respiratory Exacerbation Plans for Action and Care Transitions for Children with Severe CPR34HL153570 · NHLBI · UNIVERSITY OF WISCONSIN-MADISON · PI COLLER, RYAN J · 2021 to 2023
$727k
NHLBI NIH HHS R34 HL153570
6 · The paper itself

Abstract

objectiveTo understand caregiver, healthcare professional and national expert perspectives on implementation of a just-in-time adaptive intervention, RE-PACT (Respiratory Exacerbation-Plans for Action and Care Transitions) to prevent respiratory crises in severe cerebral palsy.

designQualitative research study.

settingPaediatric complex care programmes at two academic medical institutions.

participantsA total of n=4 focus groups were conducted with caregivers of children with severe cerebral palsy and chronic respiratory illness, n=4 with healthcare professionals, and n=1 with national experts.

methodsParticipants viewed a video summarising RE-PACT, which includes action planning, mobile health surveillance of parent confidence to avoid hospitalisation and rapid clinical response at times of low confidence. Moderated discussion elicited challenges and benefits of RE-PACT's design, and inductive thematic analysis elicited implementation barriers and facilitators.

resultsOf the 19 caregivers recruited, nearly half reported at least one hospitalisation for their child in the prior year. Healthcare professionals and national experts (n=26) included physicians, nurses, respiratory therapists, social workers and researchers. Four overarching themes and their barriers/facilitators emphasised the importance of design and interpersonal relationships balanced against health system infrastructure constraints. Intervention usefulness in crisis scenarios relies on designing action plans for intuitiveness and accuracy, and mobile health surveillance tools for integration into daily life. Trust, knowledge, empathy and adequate clinician capacity are essential components of clinical responder-caregiver relationships.

conclusionsRE-PACT's identified barriers are addressable. Just-in-time adaptive interventions for cerebral palsy appear well-suited to address families' need to tailor intervention content to levels of experience, preference and competing demands.

Indexed as

Cerebral PalsyAllied Health PersonnelChildFocus GroupsHealth PersonnelHumansQualitative ResearchPAEDIATRICSPaediatric thoracic medicineQUALITATIVE RESEARCHRespiratory infections

Identifiers

PMID37591653
PMCPMC10441064
OpenAlexW4385956054

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.