Background: An ongoing Cochrane Review of school-based asthma self-management interventions has identified a heterogeneous body of primary research. Participants, context, setting, mode, and content of interventions vary. Although previous reviews have demonstrated school-based asthma interventions may be effective, our review is using a mixed-methods design to develop an understanding of how the intervention might work, the effectiveness of different components, as well as informing the design of future interventions.
Objectives: This presentation focuses on 1) the rationale of using QCA and meta-analysis within a single review; 2) the analysis steps taken; 3) the results obtained in the QCA and their use in later stages of the review; and, 4) critically examines the challenges and benefits of using a mixed-methods design.
Methods: This study presents results from a ‘fuzzy’ set of QCA analyses that generates hypotheses about important intervention processes and design features that contribute to successful implementation. Domains of conditions were identified, and data-reduction strategies implemented, in order to keep the modelling manageable and overcome potential problems regarding limited diversity. Configurations developed through QCA were tested in meta-analysis.
Results: We present our conceptual model providing our overall rationale for employing QCA before presenting the results of conditions that are sufficient to generate successful implementation. Some of the clearest results revolve around the use/specification of theory and we discuss the further meaning of this finding. We also present a number of causal recipes found to be sufficient conditions for triggering our outcome of interest, and describe the way in which these results are used within our meta-analyses.
Conclusions: The syntheses employed in this review explicitly recognise that both the intervention design, its implementation, and the context in which it takes place are important drivers of improving children’s asthma self-management skills. QCA allows us to develop theories about the relative importance of these factors to test in meta-analyses of effectiveness.