Strengths, limitations, and future research
RECRUITMENT
The main strengths of this qualitative process evaluation are that it was conducted by a team of qualitative researchers with backgrounds in a range of disciplines, undertaken over time in phases, including developing materials and collecting data, with two researchers independently coding and analysing all data [Nevertheless, our sample was adapted to include more staff members, but we were unable to achieve our planned recruitment among families. We initially elected to recruit more staff members due to their key role in implementing the interventions within the trial–namely the algorithm. It would have been interesting to interview clinicians regarding intentional non-adherence. However, we consider that saturation was achieved among both staff and the heterogeneous family samples [The implications of the pandemic encouraged us to adopt a convenience method of sampling, as opposed to purposive, due to time constraints of healthcare professionals. It may have been more insightful to investigate perspectives of trial staff with varied years of clinical experience. Furthermore, as we were unable to interview parents and children separately, it is unclear whether they may have provided different responses.Potential areas for further exploration include the use of lung function scores in algorithm decisions and the involvement of patients and families within trial and intervention designs. It is likely that the involvement of patients and families could improve the acceptability of technological interventions in the future.