Table 4 Guidance for assessing element presence within the 14 RCT interventions

Education for professionals:

A wide range of activities were assessed as containing this element. For example, this element was considered to have a:

- Weak presence: if practitioners were simply instructed in delivering the intervention or education delivered was restricted to those providing the intervention but they were not ‘mainstream’ practitioners.

- Strong presence: if the education delivered was more complex and promoted behavioural change (for example, practitioners were taught to change their consultation style and/or there was subsequent reinforcement of professional education and/or education was offered to mainstream practitioners, not just those delivering the intervention).

Education for patients/carers:

A wide range of activities were assessed as containing this element. For example, this element was considered to have a:

- Weak presence: if patients/carers were simply offered/given asthma education as a one-off event and/or there was no/little evidence that this education was tailored to the needs of individual patients/carers.

- Strong presence: if patients/carers received in-depth asthma education tailored to their need. Such education could be delivered as a one-off session or on more than one occasion.

Partnership working:

For example, this element was considered as having a:

- Weak presence: if an intervention simply increased the opportunities for professionals, patients and carers to come together to discuss asthma and its management.

- Strong presence: If in the increased opportunities for asthma review, professionals actively encouraged patients/carers to participate in their asthma reviews and/or action plans were jointly developed. Interventions also encouraged patient/carer empowerment/enablement and opportunities for patient/professional partnership working were encouraged longer term.

Communication:

For example, this element was considered as having a:

- Weak presence: if an intervention simply provided patients/carers with additional opportunities to discuss their/child’s asthma with a professional (for example, a new asthma clinic was established). Strong presence: if the intervention improved the quality of asthma communication between patients/carers and professionals (for example, professionals actively listened to patients, encouraged patients to express their fears/anxieties and responded to these).