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This article describes a qualitative study that investigated the experiences, attitudes, and opinions of adults with asthma regarding self-managing their disease. Focus groups were conducted with 22 adults living in metropolitan and regional New South Wales, Australia. Key findings were that the perceived stigma of asthma, the need for social support, and the need for "asthma-friendly general practitioners" concerned participants more than formal self-management procedures such as written Asthma Action Plans and medication regimes. Social cognitive theory was used to explain the fluid relationship between persons with asthma, their environment, and their behavior in relation to self-management strategies and in identifying patient-centered approaches. This qualitative research suggests that asthma is viewed as a specific, individualized condition best managed from the perspective of patients' disease experience and environmental context and not one that is appropriately represented by collective, generic self-management recommendations. The authors' findings suggest that self-management outcomes can be improved by recognizing the variance in self-efficacy levels between individuals and tailoring environmental and social support strategies around these. Abstract:This article describes a qualitative study that investigated the experiences, attitudes and opinions of adults with asthma regarding self managing their disease. Focus groups were conducted with 22 adults living in metropolitan and regional New South Wales, Australia.Key findings were that the perceived stigma of asthma, the need for social support and the need for "asthma-friendly general practitioners" concerned participants more than formal self-management procedures such as written Asthma Action Plans and medication regimes.Social cognitive theory was used to explain the fluid relationship between persons with asthma, their environment, and their behavior in relation to self-management strategies and in identifying patient-centered approaches. This qualitative research suggests that asthma is viewed as a specific, individualized condition best managed from the perspective of patients' disease experience and environmental context and not one that is appropriately represented by collective, generic self-management recommendations. The authors' findings suggest that self-management outcomes can be improved by recognizing the variance in self-efficacy levels between individuals and tailoring environmental and social support strategies around these.2

Youth alcohol consumption has been steadily declining in Australia, as in other countries; fewer young people are drinking and the age of initiation is increasing. However, young people, their parents and others in their communities continue to believe that adolescent (excessive) drinking is the norm. This perception, and the concurrent misperception that the majority of parents are happy to provide their underage children with alcohol, creates a perceived culture of acceptance of youth alcohol consumption. Young people believe that it is accepted, and even expected, that they will drink; and parents perceive that not providing their adolescent children with alcohol will lead to social exclusion. There is evidence that shifting social norms can have an immediate and lasting effect adolescents’ (and adults’) alcohol related attitudes and behaviors. This paper reports on a novel, community based social marketing intervention designed to correct misperceptions of alcohol related social norms in an Australian community. The project utilized a social marketing approach, informed by the full complement of Andreasen’s social marketing benchmarking criteria, and concurrently targeted adolescents, parents of adolescents and the broader community. Using extensive formative research and multiple evaluation techniques, the study demonstrates that shifts in community social norms are possible and suggests that this approach could be used more widely to support the positive trends in youth alcohol consumption and parental supply.

BackgroundReductions in underage drinking will only come about from changes in the social and cultural environment. Despite decades of messages discouraging parental supply, parents perceive social norms supportive of allowing children to consume alcohol in ‘safe’ environments.MethodsTwelve focus groups conducted in a regional community in NSW, Australia; four with parents of teenagers (n = 27; 70 % female) and eight with adolescents (n = 47; 55 % female). Participants were recruited using local media. Groups explored knowledge and attitudes and around alcohol consumption by, and parental supply of alcohol to, underage teenagers; and discussed materials from previous campaigns targeting adolescents and parents.ResultsParents and adolescents perceived teen drinking to be a common behaviour within the community, but applied moral judgements to these behaviours. Younger adolescents expressed more negative views of teen drinkers and parents who supply alcohol than older adolescents. Adolescents and parents perceived those who ‘provide alcohol’ (other families) as bad parents, and those who ‘teach responsible drinking’ (themselves) as good people. Both groups expressed a preference for high-fear, victim-blaming messages that targeted ‘those people’ whose behaviours are problematic.ConclusionsIn developing and testing interventions to address underage drinking, it is essential to ensure the target audience perceive themselves to be the target audience. If we do not have a shared understanding of underage ‘drinking’ and parental ‘provision’, such messages will continue to be perceived by parents who are trying to do the ‘right’ thing as targeting a different behaviour and tacitly supporting their decision to provide their children with alcohol.

The findings suggest that these respondents (parents) harboured a number of misperceptions about underage drinking and experienced conflicts in weighing up the perceived benefits of providing alcohol to their children against the risks of adolescent drinking. [Jones SC, Magee C, Andrews K. 'I think other parents might. …': Using a projective technique to explore parental supply of alcohol. Drug Alcohol Rev 2015;34:531-9].