Table 3 Summary of similarities and differences between South Asian and White British families across themes

 Environmental and physiological/genetic factors were the most commonly mentioned ‘causes’ across all groups

Fate, destiny or religion were more likely to be mentioned by South Asian families

 Approximately one-third of all families specifically stated that they felt unclear about the origins of asthma

South Asian families were more likely to mention the UK environment as a trigger of an asthma exacerbation

 The perception that asthma is something children can grow out of was similar across both groups

South Asian families were less likely to have prior knowledge about asthma unless they had familial experience of it

White British families were more likely to know that asthma was a condition that existed even without previous familial experience of it

 Extended families, friends and wider community often offered advice about asthma management. Families often did not consider this an important or reliable source of information about asthma

South Asian families were more likely to report receiving advice from extended family, especially in relation to alternative therapies and remedies for asthma. Advice sometimes extended to family members living in South Asia

South Asian families were more likely to have extended family living with them and these relatives were more likely to have a role in caring for a child with asthma

South Asian families were more likely to report negative reactions from others about their child’s asthma

 A lack of timely, consistent information-giving by HCPs was reported by both South Asian and White British families

South Asian families whose first language was not English reported needing to access primary care staff who spoke the same language

 Families would prefer information to be given both face to face by HCPs and in written form for later use

 Consistency of advice and information from all HCPs was important for both South Asian and White British families

 No one had received a written asthma plan

 Both South Asian and White British families were often confused about the correct use of medicines for asthma and in some cases about inhaler technique

South Asian families mentioned a wider range of possible side effects

 Parents generally took responsibility for medicines until a child was considered able to do this for him- or herself

 Families used a number of strategies to help with adherence, including the use of spacers

 South Asian and White British families had concerns about the side effects of asthma medicines, particularly in relation to the long-term use of steroids

 Both South Asian and White British parents described actively making decisions to increase or reduce the dosage of medicines given to children, which was sometimes at odds with the advice they had received from HCPs

 Both South Asian and White British families discussed the adaptations and non-medical management strategies they have tried to relieve asthma symptoms

South Asian families tended to use more additional measures such as keeping the child warm

 Both groups had made changes to the home and environment

South Asian families were more likely to try religious, herbal or alternative therapies and modify a child’s diet

 Getting a diagnosis for asthma was experienced often as a difficult and lengthy process for both South Asian and White British families

White British families were more likely to describe accessing the GP out-of-hours service in an emergency or non-routine situation

 There was a perception among families that HCPs (usually the GP) did not take their concerns seriously or were reluctant to make a diagnosis

South Asian families were more likely to describe self-referral to the ED

 Not having a diagnosis for their child’s symptoms led to a great deal of uncertainty about the best course of action for families

South Asian families were less likely to be attending an asthma review and were more likely to be seeking additional information from pharmacists

 South Asian and White British families had similar concerns about the quality of healthcare services and staff. These particularly related to inconsistency, HCPs not doing their job properly and ineffective communication skills

Concerns over the quality of health care were exacerbated for those whose first language was not English

 South Asian and White British families valued staff who were knowledgeable, informative and able to communicate effectively, who were supportive, caring and were child-friendly