Implementing enhanced paediatric asthma care in rural Australia: qualitative insights from healthcare professionals

Background: Healthcare professionals (HCPs) face barriers delivering effective paediatric asthma care, particularly in rural areas due to fragmented care, resource constraints, geographic, workforce and educational challenges. As part of the Asthma Care from Home project, we implemented a multicomponent asthma model of care for children in regional Australia, comprising educational resources, post-discharge communication and nurse-led virtual follow-up visits to standardise care, improve access and reduce hospitalisations. This study explored HCP perspectives on implementation to assess real-world feasibility in rural settings. Methods: This qualitative study explored contextual factors influencing HCP implementation. Purposive and convenience sampled HCPs from thirteen participating hospitals across four rural New South Wales Local Health Districts participated in virtual focus groups and semi-structured interviews. Interview guides were informed by the Consolidated Framework for Implementation Research, and data were analysed using hybrid inductive-deductive thematic analysis. Results: Twenty-five HCPs participated in eight interviews and five focus groups. Three themes emerged: (1) Acceptability: HCPs valued standardised resources improving care consistency and virtual home visits overcoming geographic barriers, but identified challenges including variable parental engagement, General Practitioner accessibility, and workforce instability; (2) Standardisation: the model achieved consistent, equitable care with improved guideline adherence and enhanced hospital-community collaboration, strengthening HCP confidence and parent knowledge; (3) Transitioning to standard practice: participants advocated for continuation, suggesting digitised resources and greater integration into nurse-led pathways for sustainability. Conclusion: HCPs found the asthma care model feasible and acceptable despite rural healthcare challenges. Findings highlight the potential to embed the model within routine clinical practice in rural settings.