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

## TL;DR

This paper outlines a research protocol to improve asthma management in Australian primary care by developing a practical implementation bundle through co-design with stakeholders.

## Contribution

The study introduces a co-designed, evidence-based asthma implementation bundle tailored for general practice settings in Australia.

## Key findings

- Phase I will refine a multicomponent asthma implementation bundle through evidence synthesis and co-design workshops.
- Clinical workflows and contextual factors in general practices will be mapped to inform tailored implementation strategies.
- Outputs will support real-world simulation, testing, and eventual scale-up of asthma management improvements.

## Abstract

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.

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).

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.