title: Understanding influences and decisions of households with children with asthma regarding temperature and humidity in the home in winter: a qualitative study.
abstract: OBJECTIVE
  This study aimed to understand the influences and decisions of households with children with asthma regarding keeping warm and well at home in winter.
  
  
  METHODS
  Community settings in Rotherham and Doncaster, South Yorkshire, UK.
  
  
  METHODS
  Individuals from 35 families and 25 health, education and social care staff underwent interview. 5 group interviews were held, 1 with parents (n=20) and 4 with staff (n=25).
  
  
  METHODS
  This qualitative study incorporated in-depth, semistructured individual and group interviews, framework analysis and social marketing segmentation techniques.
  
  
  RESULTS
  The research identifies a range of psychological and contextual influences on parents that may inadvertently place a child with asthma at risk of cold, damp and worsening health in a home. Parents have to balance a range of factors to manage fluctuating temperatures, damp conditions and mould. Participants were constantly assessing their family's needs against the resources available to them. Influences, barriers and needs interacted in ways that meant they made 'trade-offs' that drove their behaviour regarding the temperature and humidity of the home, including partial self-disconnection from their energy supply. Evidence was also seen of parents lacking knowledge and understanding while working their way through conflicting and confusing information or advice from a range of professionals including health, social care and housing. Pressure on parents was increased when they had to provide help and support for extended family and friends.
  
  
  CONCLUSIONS
  The findings illustrate how and why a child with asthma may be at risk of a cold home. A 'trade-off model' has been developed as an output of the research to explain the competing demands on families. Messages emerge about the importance of tailored advice and information to families vulnerable to cold-related harm.
authors.affiliation: Faculty of Medical and Human Sciences, School of Nursing, Midwifery and Social Work/Central Manchester NHS Foundation Trust, University of Manchester, Manchester, England.
authors.forename: Angela Mary
authors.identifier: http://orcid.org/0000-0001-6336-3747
authors.initials: AM
authors.lastname: Tod
authors.affiliation: Faculty of Health and Wellbeing, Department of Social Work, Social Care and Community Studies, Sheffield Hallam University, Sheffield, England.
authors.forename: Peter
authors.initials: P
authors.lastname: Nelson
authors.affiliation: Faculty of Health and Wellbeing, Centre for Health and Social Care Research, Sheffield Hallam University, Sheffield, England.
authors.forename: Anna
authors.initials: A
authors.lastname: Cronin de Chavez
authors.affiliation: Faculty of Health and Wellbeing, Centre for Health and Social Care Research, Sheffield Hallam University, Sheffield, England.
authors.forename: Catherine
authors.initials: C
authors.lastname: Homer
authors.affiliation: Public Health, Doncaster Council, Doncaster, England.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Powell-Hoyland
authors.affiliation: Communications, NHS England, The North West, England.
authors.forename: Amanda
authors.initials: A
authors.lastname: Stocks
mesh_terms: D000328:Adult; D001249:Asthma; D002648:Child; D003080:Cold Temperature; D003657:Decision Making; D005190:Family; D005191:Family Characteristics; D005260:Female; D005658:Fungi; D007722:Health Knowledge, Attitudes, Practice; D006798:Housing; D006801:Humans; D006813:Humidity; D008297:Male; D008875:Middle Aged; D010290:Parents; D036301:Qualitative Research; D012307:Risk Factors; D013315:Stress, Psychological; D013696:Temperature; D006113:United Kingdom; D014867:Water; D055815:Young Adult
chemical_list: D014867:Water
keywords: PREVENTIVE MEDICINE; PUBLIC HEALTH; QUALITATIVE RESEARCH