Developing a theory-based multimedia intervention for schools to improve young people's asthma: my asthma in school (MAIS).

Background: Asthma control in adolescents is low with half of the young people in a London study identified as having suboptimal control when measured using the Asthma Control Test. Control of asthma symptoms can be improved by addressing barriers to good self-management, such as poor understanding of asthma and adherence to medication. The aim of this study was therefore to develop the My Asthma in School (MAIS) intervention for the improvement of asthma control and self-management in adolescents and to test its initial feasibility. The intervention intended to combine a strong focus on theory with a design specifically aimed to engage adolescents. Methods: The intervention development was based on previous qualitative and quantitative findings, and on guidelines from the Medical Research Council for the development of complex interventions. The COM-B (Capability, Opportunity, Motivation-Behaviour) model was applied to inform the design of intervention elements. Behavioural targets were identified from existing barriers to good asthma self-management and were then used to guide the development of engaging intervention elements, which were described using the Behavioural Change Technique (BCT) Taxonomy version 1. Adolescents were involved throughout this process. The MAIS intervention was tested in a feasibility phase in London secondary schools with adolescents aged between 11 and 13. Results: The complex school-based MAIS intervention comprised a first school visit from a theatre group, who conducted a workshop with all year 7-8 students and addressed peer understanding and attitudes to asthma. The second visit included four self-management workshops for adolescents with asthma, including games, short-films and role play activities. Forty different types of techniques to change behaviour were applied, totalling 163 instances of BCT use across intervention elements, addressing all areas of capability, opportunity and motivation. In this initial feasibility study, 1814 adolescents with and without asthma from nine schools received the theatre intervention visit; 23 adolescents with asthma from one of the schools attended the workshop visit. The intervention was found acceptable and engaging, and 91.4% of participants agreed that the workshops changed how they think or feel about asthma. Conclusion: This study demonstrates development and initial feasibility of a complex theory-based intervention, and how it can combine engaging media and interactive elements, to achieve a multi-directional approach to behavioural change. However more work is needed to assess the feasibility of trial processes, including recruitment and delivery format of the workshops

Pediatric Oncology

This chapter provides an overview of key considerations when providing consultation-liaison services to pediatric oncology patients and their families. The chapter offers a brief overview of medical basics that are important to understand when working with this population. Strategies to enhance patient and family engagement and the benefits of early initiation of psychological consultation for youth with cancer are presented. The chapter provides an overview of case formulation, with an emphasis on primary domains to assess when completing an initial consult (e.g., medical history, family history, physical, emotional, cognitive, social, developmental, behavioral, academic, and socio-cultural), as well as examples of specific information to obtain within each domain. A succinct review of evidence-based psychological interventions that are most relevant to working with youth with cancer and their families is provided (e.g., coping and adjustment, behavioral concerns, adherence, physical symptoms, and end-of-life issues). Also included is information about the adaptation of psychology services, including a discussion of how service provision may differ across settings (i.e., inpatient unit, outpatient oncology clinic, and outpatient psychology clinic). Finally, a case example highlights the process of completing an initial psychology consultation for a newly diagnosed child with cancer and implementing targeted interventions. A Table included in the Appendix provides sample consultation questions for patients and caregivers across suggested domains. (PsycInfo Database Record (c) 2022 APA, all rights reserved