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

From: A qualitative study to identify parents’ perceptions of and barriers to asthma management in children from South Asian and White British families

Similarities Differences
Beliefs and Understandings of Asthma
 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
Reactions from others
 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
Information about 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
Medicines
 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
Non–Medical Management
 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
Interactions with the NHS
 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