Abstract Rationale Despite the availability of effective therapies, controlling asthma remains a challenge for many patients with varied success of prior education programs. One limitation is educational programs are rarely co-created with patients and often fail to account for social realities shaping daily disease management. Patients living in neighborhoods with high area deprivation index (ADI) scores face distinct challenges resulting in worse health outcomes. Therefore, we sought to perform a qualitative pilot study to identify patient-perceived barriers and promoters of asthma control and to translate these insights into design recommendations for accessible educational materials. Methods Semi-structured interviews of 30 minutes were conducted with six adults with physician-diagnosed asthma who reside in a high-ADI neighborhood (≥75 national score). Interview questions were informed by the Whitehead social determinants of health model to probe multiple levels of influence (individual, social relationships, living/working conditions, and socioeconomic/cultural environment). Transcripts were coded inductively in NVivo and refined through team consensus (FAA/LJH). The resulting themes were organized into higherorder domains to guide intervention design, which were collated into a conceptual framework. Results Four major themes were identified: (1) impact of disease, (2) barriers to asthma control, (3) facilitators of asthma management, and (4) educational preferences. Delayed diagnosis was one of the factors that hindered proper care delivery since the patients considered the symptoms part of their life, workplace exposures and allergens that were unavoidable, costs of medicines and complexities of the insurance system, and lack of personalized asthma action plans. Participants reported suboptimal treatment patterns, such as reliance on rescue inhalers and visiting the emergency department. Persistent unmet needs were guidance around pregnancy, weight management, exercise, and clear, actionable steps to take during exacerbations (i.e., an asthma action plan). Promoters of asthma control were proactive asthma management (e.g., alarms and organizers to facilitate consistent maintenance inhaler use), perceived trustworthiness of healthcare providers, family involvement, and access to advanced therapies (e.g. biologics). For patient education, the preferred delivery method was short visual materials (e.g., videos, infographics, or animations) rather than pamphlets; they also considered clinicians and their families to be the most trustworthy information sources. Conclusions Although our asthma participants reported multiple barriers, there is an expressed desire for reputable asthma education tools. Short and simple formats enriched with visual elements were preferred and instructions on managing exacerbations, triggers, exercise, nutrition, and pregnancy. Addressing patients abilities to navigate systemic barriers such as medication affordability and insurance navigation remains critical. This abstract is funded by: NA
Albuainain et al. (Fri,) studied this question.