Asthma UK Centre for Applied Research

Project: BREATHE4T

Breathing Retraining for Asthma Trial of Home Exercises for Teenagers (BREATHE4T); repurposing, refining and feasibility

This multi-disciplinary programme of work is aiming to find out if we can repurpose the effective, adult BREATHE breathing retraining intervention to create an age-appropriate intervention for young people with asthma and to demonstrate acceptability and feasibility in this population.

Young people with asthma have impaired quality of life despite using appropriate medication. Many experience dysfunctional breathing. Our DVD delivered breathing retraining programme (BREATHE) improved quality of life in adult asthma but there is no robust evidence for the value of breathing retraining in younger patients. Our recent work with this age group would suggest that the adult intervention would need to be redesigned to be appropriate for, and acceptable to, young people.

Specific objectives

1. To use theory-, evidence- and person-based behavioural analysis to identify the key, young person specific, behavioural issues, needs and challenges that the intervention must address (Stage 1).

2. To develop and optimise the intervention (Stage 2).

3. To undertake a feasibility trial assessing acceptability and feasibility of the intervention (Stage 3).

We're recruiting young people (12-17 years) with physician-diagnosed asthma and impaired quality of life, mostly from primary care and hospital clinics using the CRN network. We're working in collaboration with AsthmaUK, who will provide publicity and an additional recruitment route.


A self-guided, breathing retraining digital intervention, delivered via a mobile-friendly, online platform.

Repurposing, optimisation, acceptability, feasibility

We will follow a theory-, evidence- and person-based approach:

  • Stage 1: intervention planning: Conduct a behavioural analysis to identify key, adolescent specific, behavioural issues, needs and challenges that the intervention must address, drawing on literature, qualitative interviews and consultation with study Patient and Public Involvement (PPI) panels.
  • Stage 2: intervention development: Development of intervention components, with active involvement of PPI panels and optimisation using feedback from qualitative interviews to ensure the intervention is acceptable and engaging.
  • Stage 3: feasibility trial: Trialling of breathing retraining intervention in real-life context to evaluate acceptability and feasibility in practice. A total of 116 young people with asthma will be randomised to the intervention or control and reassessed after 6 months. Key objectives are to assess acceptability, uptake, success in collecting follow up data and variance in asthma-related outcome measures.

BREATHE4T project

Get Involved

Are you, or do you know anyone who is, 12-17 years old and living with asthma? 

Help the BREATHE4T team find out if a new website can help teenagers manage their asthma better and improve their overall lives!

BREATHE4T study recruitment website

Key People

Professor Graham Roberts

Graham Roberts

Stephanie Easton

Stephanie Easton

Chief Investigator and Consultant Paediatrician Trial Co-ordinator and PhD student
Based at: University Hospital Southampton Based at: University Hospital Southampton
Graham's Profile Stephanie's PhD Profile
Dr Ben Ainsworth

Ben Ainsworth

Professor Mike Thomas

Mike Thomas

Digital Intervention Development Lead Primary Care Lead

Based at: University of Bath

Based at: University of Southampton

Ben's Profile Mike's Profile
Dr Erika Kennington

Erika Kennington

Dr Rebecca Knibb

Rebecca Knibb

Asthma UK and British Lung Foundation Partnership Lead Expert in Behaviour Change

Based at: University of Aston

  Rebecca's Profile
Professor Sue Latter

Sue Latter

Dr Amy Whitehead

Amy Whitehead

Qualitative Lead Statistics Lead
Based at: University of Southampton Based at: Southampton Clinical Trials Unit
Sue's Profile Amy's Profile
Dr Denise Gibson

Denise Gibson

Mike Bahrami-Hessari

Mike Bahrami-Hessari

Physiotherapy Lead Patient and Public Involvement Lead
Based at: University Hospital Southampton

Based at: University Hospital Southampton

Amber Cook

Amber Cook

Research Nurse
Based at: University Hospital Southampton


August 2019 - December 2021

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The project is funded by the National Institute for Health Research (NIHR), under the programme grant Research for Patient Benefit (RfPB).