Integrating evidence-based paediatric asthma management in Australian primary care: phase I protocol for developing implementation bundles.

Introduction: Asthma is the most common chronic respiratory condition among Australian children. However, adherence to clinical guidelines for paediatric asthma care in general practice (GP) settings requires attention-it is estimated to be below 60% in some contexts. The National Paediatric Applied Research Translation Initiative (N-PARTI) is a three-phased, co-designed research program aiming to optimise guideline-concordant paediatric care across three priority conditions, including asthma, Type 1 Diabetes (T1D), and antibiotic stewardship in Australian general practices. This protocol outlines Phase I of the N-PARTI asthma stream, focusing on developing an Implementation Bundle to support evidence-based asthma management in general practices. Methods and analysis: Using a mixed-method design, Phase I will employ a multi-method, co-design approach comprising three Aims: (i) to verify and refine a multicomponent asthma Implementation Bundle tailored for general practice through evidence synthesis, and co-design workshops, involving children with asthma and their parents and carers, alongside with key stakeholders; (ii) to map asthma-related clinical workflows across diverse general practice settings through interviews and observations, analysed using the Functional Resonance Analysis Method (FRAM) to capture variations in routine practice; and (iii) to explore contextual factors within Primary Health Networks (PHNs) through stakeholder interviews, informing the development of locally tailored implementation strategies. Qualitative data will be analysed using a reflexive thematic analysis approach informed by the Consolidated Framework for Implementation Research (CFIR). Outputs will include a refined, contextually adapted paediatric asthma Implementation Bundle and resources to support real-world simulation, testing and tailoring (Phase II), as well as the scale-up, embedding and evaluation of the implementation (Phase III). Ethics and dissemination: This research project has been approved by the Macquarie University Human Research Ethics Committee (Reference No. 520251855660911). Findings will be disseminated through peer-reviewed publications, conferences, stakeholder forums, and policy briefings. Co-designed outputs will also be shared with participating PHNs to inform wider implementation and scale-up efforts.