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12 The present study will overcome this barrier, because the intervention will be delivered by trained respiratory nurses.
Further, because the intervention will use a smartphone application, employees who do not own such a device are excluded from this study.
A cost analysis is being conducted as part of SPIRIT because: the intervention will include non-market goods for which standardised cost estimates are less likely to exist.
A limitation of the study is that differences in the care provided to participants in the second and third feedback conditions other than the intervention can arise (performance bias), because the intervention will be focused on the clinician.
We chose a cluster randomised controlled trial because the intervention will be delivered at the level of children's centres and to prevent contamination between treatment arms that could have arisen through individual treatment arm allocation of families living in close proximity.
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Cluster randomization is required because the interventions will be implemented at the school level.
We expect ρB to be smaller than p (even within the treatment groups), because the interventions will be 'between' the baseline and follow-up assessments.
This is important because if interventions are not for example adequately adopted and sustained it is unlikely that the intervention will have a public health impact.
We also expect that attrition during the interventions will be substantial, because families view a weekly participation of their children in such a programme as a high demand on their daily routine.
The interventions will run up until December.
Intervention: The interventions will comprise three groups.
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