Design and Implementation of a Carer Aromatherapy Training (CAT) Program for Children With Global Developmental Delay in Hong Kong: a Mixed Qualitative Study Using the COM-B Framework

Purpose Global developmental delay (GDD) involves significant delays in two or moredevelopmental domains and affects approximately 1‐3% of children under the age of 5 yearsworldwide.The causes of Global Developmental Delay (GDD) are often unknown; however, whenidentified, they are most commonly associated with genetic factors such as chromosomalabnormalities, single‐gene disorders, or copy number variations.Study Designs The Capacity, Opportunity and Motivation Behaviour (COM‐B) model will beused to design and implement a Carer Aromatherapy Training (CAT) program. COM‐B model isa theoretical framework for understanding and supporting behaviour change, consisting ofsix components that are hypothesised to drive behaviour change, namely capacity (physicalcapability and psychological capability), opportunity (physical opportunity and socialopportunity) and motivation (reflective motivation and automatic motivation). This designallows for a comprehensive understanding of behavioural changes among carers by firstidentifying measurable outcomes and then exploring the underlying experiences andcontextual factors.The study employed a mixed‐methods approach to have a better understanding both thequantitative outcomes of behaviour change and the qualitative experiences of carers ofchildren diagnosed with global developmental delay in Hong Kong during and aftertraining.Carer Aromatherapy Training (CAT) program This program aims to provide aromatherapytraining to carers of children diagnosed with GDD in Hong Kong to: i) provide standardtraining in aromatherapy for carers of children diagnosed with GDD; ii) improve theinteraction between carers and children diagnosed with GDD; and iii) explore the changesin carers' capability, opportunity and motivation to use aromatherapy in daily careroutines.Following participants' consent to participate, a a one‐day (8‐hour) face‐to‐facetraining program will be given to carers being recruited in the study. The program willbe held in activity rooms of Special Child Care Centres (SCCC) or classrooms. It consistsof three modules: (1) Introduction of aromatherapy massage with safety concerns, (2)demonstration of massag steps and (3) return demonstration.One session of introduction will be given to staffs by certified IFPA aromatherapy nursein centres on the first session of training programme for introducing the theories ofaromatherapy, the possible benefit behind and safety issues they must be aware of.Afterwards, massage sessions will be demonstrated with standardised effleurage, whichmould our hands to the shape of the body being massaged on abdomen and four limbs andreturn demonstrated. Massage oil with the mixture of Petitgrain Mandarin (Citrusreticulate) essential oil and fractionated coconut carrier oil will be used.After the training program, each carer is required to provide a 4‐week aromatherapymassage to his/her child (twice per week for around 10‐15 minutes).Incentive to participants To increase the compliance and incentive of participants tocomplete the whole training program, HK$150 supermarket coupon will be given to eachcarer who finished the whole program and focus group interview for investigating theadaptation of CAT programme and a job satisfaction questionnaire.After the training program, each carer is required to provide a 4‐week aromatherapymassage to his/her child (twice per week for around 10‐15 minutes).Qualitative data from semi‐structured interviews and focus groups with questions setbased on COM‐B framework will be audio‐recorded, transcribed verbatim and organized usingfield notes with the help of Nvivo 12. Quantitative data will be collected as theparental stress level using the Chinese version of the Parenting Stress Index (PSI‐SF)(4th version) through pre‐ and post‐training surveys and analysed using descriptivestatistics and t‐test to measure changes in carers motivation and behaviour before andafter the CAT programme intervention.Expected Outcomes and implications Integration of findings will provide a comprehensiveunderstanding of the training's impact. If the programme is effective, carers will gainimproved capability through targeted training, leading to greater confidence indelivering person‐centred care. Besides, by addressing motivational factors and creatingsupportive opportunities, carers can reduce parental stress and burnout as well asimproving wellbeing of both carers and children with physical disability.For the population, children with physical disability will benefit from more consistent,empathetic, and responsive care, which can enhance their overall health, wellbeing, anddignity.