Living With COPD and Views on Digital Health Tools Among Pacific Peoples and Family Carers in Aotearoa New Zealand: A Qualitative Study

BACKGROUND: Chronic Obstructive Pulmonary Disease (COPD) disproportionately affects Pacific peoples in Aotearoa New Zealand, with higher incidence, prevalence, and hospitalisation rates than non-Māori, non-Pacific populations. Despite this inequity, little qualitative research has explored how Pacific peoples and their families experience living with COPD, or their perspectives on emerging digital health technologies. METHODS: This study adopted a qualitative design informed by talanoa methodology to explore the experiences of Pacific peoples living with COPD and their family caregivers. Participants were purposively recruited through Pacific community and professional networks. Talanoa sessions were audio-recorded, transcribed verbatim, and analysed using a general inductive approach to identify key themes and subthemes. RESULTS: Three interconnected themes were identified: (1) living with COPD, characterised by delayed diagnosis, constant vigilance, and repeated hospitalisation; (2) the central role of family in COPD management, with family members acting as caregivers and clinical partners within culturally grounded, collective systems of care; and (3) attitudes toward digital health tools. Participants expressed openness to digital health technologies to support COPD management, provided these tools were simple, reliable, culturally accessible, and designed to complement, not replace existing self-management and family-based care practices. CONCLUSION: Living with COPD for Pacific peoples is experienced as a collective and relational journey shaped by family, cultural values, and caregiving obligations, extending beyond individualised models of COPD self-management. Family members play essential roles in managing COPD, yet this labour often remains unrecognised within formal health systems. Digital health tools offer potential to support COPD care if they are co-designed with Pacific communities, align with Pacific values, and integrate within existing clinical and community care pathways. These findings highlight the need for culturally grounded, family-inclusive approaches to COPD services and digital health innovation to advance health equity for Pacific peoples. PATIENT OR PUBLIC CONTRIBUTION: Patients living with COPD and family caregivers were central to this study as participants, contributing their lived experiences and perspectives. The study was guided by a Pacific relational approach that centred participant voices and the role of family in COPD care. Patients and the public were not involved in drafting the manuscript.