Experiences addressing health-related financial challenges with disease management among African American women with asthma

Abstract

Objective: Despite economic hardship, compliance with self-management regimens is still evident among individuals and families managing chronic disease. The purpose of this study was to describe how women with asthma address cost-related challenges to management of their condition. Methods: In 2012 and 2013, four focus groups were conducted in Southeast Michigan with 26 African American women with asthma, recruited based on maximum variation sampling procedures. A semi-structured interview protocol was employed by trained facilitators. Coded transcripts were analyzed for themes regarding means to reduce the impact of the cost of asthma management. Results: Major themes identified were acceptance of the status quo; stockpiling and sharing medicines; utilizing community assistance programs; reaching out to healthcare providers and social networks for help; foregoing self-management; and utilizing urgent care. Conclusions: Awareness of strategies that are helpful to patients in reducing out-of-pocket costs may better equip service providers and others to develop interventions to make useful strategies more widely available.

• Adherence
• asthma
• barriers
• disparities
• self-management

Acknowledgements

The authors would like to thank Katherine Faiver, Emily Salvette, Meagan Shallcross and Edward Tsai for their assistance with preparing the focus groups, Peter Song, Melissa Valerio and Jack Wheeler for feedback on the work presented here and Lauren Nichols for her assistance preparing the manuscript. Many thanks to the Women of Color and Asthma Control Study Team for providing access to participants and expert feedback on the discussion guide. This work is dedicated to the loving memory of Dr. Noreen M. Clark, Director of the Center for Managing Chronic Disease at the University of Michigan School of Public Health.