Acceptability and feasibility of co-designed hybrid tele-physiotherapy for children with difficult asthma: a mixed-methods study.

BACKGROUND: Respiratory physiotherapists address causes of poor asthma control, including breathing pattern disorders (BrPD) affecting symptoms and quality-of-life. Co-designed hybrid physiotherapy services and digital resources have been created for children and young people (CYP) with asthma and BrPD. AIM: To assess acceptability and feasibility of co-designed online resources, a digital platform, and hybrid physiotherapy services for CYP with asthma and BrPD. METHODS: Prospective mixed-methods study recruited CYP and carers from a severe asthma clinic. Participants accessed hybrid physiotherapy clinics (Attend Anywhere), online resources (hospital website, Beam Asthma Kids platform), and live group classes over 12-weeks. Acceptability was assessed using questionnaires, feedback, and physiotherapist diaries; feasibility through attendance and website analytics. RESULTS: Twenty-five CYP aged 7-16 years participated; all completed the programme with no intervention-related adverse events. Eighteen (72%) created Beam Asthma Kids profiles to access live classes, videos, or programmes. Hospital website videos received 296 views from 68 viewers over six-months. Feedback demonstrated high acceptability of the co-designed digital resources. Participants valued usability, accessibility and flexibility of the Beam Asthma Kids and hybrid services, while identifying hospital webpage navigation, technical issues and digital inclusion as implementation considerations. Across 32 clinics, 94 consultations occurred (27 in-hospital, 67 virtual); non-attendance was higher for virtual sessions (42% vs 20%). CONCLUSION: Co-designed physiotherapy resources and hybrid services were acceptable and positively received by CYP with asthma and BrPD. Hybrid physiotherapy may complement care by improving flexibility and access, but technical challenges and virtual non-attendance require attention to optimise implementation.