WS05.5 Developing an audio-visual intervention to support children's adherence to home chest physiotherapy for cystic fibrosis

Objectives: To develop and test an audio-visual supportive intervention to improve adherence to home chest physiotherapy among young children aged 0−8 years with cystic fibrosis (CF) and their parents. Adherence is important because lung damage occurs rapidly and can be irreversible. However, only 50% of parents and young children adhere to their recommended physiotherapy regimen. Interventions to address this significant problem are lacking.

Methods: We co-developed a theory-informed film and adherence plan over 8 months with a purposively recruited online group of 14 parents of 13 children aged 0.5 to 8.5 years and 8 NHS clinicians in the UK. We qualitatively analysed data to identify parent preferences for the intervention, barriers and solutions to adherence, and parents’ use of behaviour change techniques (BCTs). Clinicians ratified parents’ solutions.

Results: There are parent, child, and societal/ external barriers to physiotherapy adherence. Many, but not all, of parents’ solutions correspond to known BCTs e.g. distraction and habit formation. Parents wanted a family film to convey ways to make physiotherapy more enjoyable and to explain to children the need for physiotherapy. Our film incorporates BCTs into an entertaining narrative featuring real families and cartoon-style animation to motivate parents and suggest strategies to encourage adherence. We are now feasibility testing the intervention.

Conclusion: After a future full-scale trial, this resource could help increase physiotherapy adherence in young children with CF and so decrease the likelihood of lung damage and medical complications, reducing health burden and costs to families and the NHS.