Implementation of a strategy to facilitate effective medical follow-up for Australian First Nations children hospitalised with lower respiratory tract infections: study protocol

André Schultz, Anne B. Chang, Fenella Gill, Roz Walker, Melanie Barwick, Sarah Munns, Matthew N. Cooper, Richard Norman, Pamela Laird

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    Background: First Nations children hospitalised with acute lower respiratory infections (ALRIs) are at increased risk of future bronchiectasis (up to 15–19%) within 24-months post-hospitalisation. An identified predictive factor is persistent wet cough a month after hospitalisation and this is likely related to protracted bacterial bronchitis which can progress to bronchiectasis, if untreated. Thus, screening for, and optimally managing, persistent wet cough one-month post-hospitalisation potentially prevents bronchiectasis in First Nations’ children. Our study aims to improve the post-hospitalisation medical follow-up for First Nations children hospitalised with ALRIs and thus lead to improved respiratory health. We hypothesize that implementation of a strategy, conducted in a culturally secure manner, that is informed by barriers and facilitators identified by both parents and health care providers, will improve medical follow-up and management of First Nations children hospitalized with ALRIs. Methods: Our trial is a multi-centre, pseudo-randomized stepped wedge design where the implementation of the strategy is tailored for each study site through a combined Participatory Action Research and implementation science approach informed by the Consolidated Framework of Implementation Research. Outcome measures will consist of three categories related to (i) health, (ii) economics and (iii) implementation. The primary outcome measure will be Cough-specific Quality of Life (PC-QoL). Outcomes will be measures at each study site/cluster in three different stages i.e., (i) nil-intervention control group, (ii) health information only control group and (iii) post-intervention group. Discussion: If our hypothesis is correct, our study findings will translate to improved health outcomes (cough related quality of life) in children who have persistent wet cough a month after hospitalization for an ALRI. Trial registration ACTRN12622000224729, prospectively registered 8 February 2022, URL:

    Original languageEnglish
    Article number92
    Pages (from-to)1-16
    Number of pages16
    JournalBMC Pulmonary Medicine
    Issue number1
    Publication statusPublished - Mar 2022

    Bibliographical note

    Funding Information:
    Dr. Laird is funded by a Raine Fellowship, A/Prof Schultz is supported by an NHMRC/MRFF Investigator Grant [APP1193796]. Prof Chang is supported by an NHMRC Practitioner Fellowship [Grant 1058213] and a Queensland Children’s Hospital Foundation top-up [Grant 50286] and has received multiple NHMRC grants related to topics of cough and bronchiectasis including Centre of Research Excellence grants for lung disease [Grant 1040830] among Indigenous children and bronchiectasis [Grant 1170958]. All other authors have no competing interests.

    Publisher Copyright:
    © 2022, The Author(s).


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