LAUSR

Introduction: Adjusting to life with a chronic condition is particularly challenging for people with limited health literacy. We aimed to explore the views and experiences of people with limited health literacy on managing their asthma. Methods: We purposively sampled adults with asthma and limited health literacy (using HLS-Q47) from 5 primary healthcare clinics in Malaysia. We conducted semi-structured interviews in participants’ preferred language, and invited participation in Photovoice: (1) One-week photo-taking (2) Post-photo interview. Interviews were audio-recorded, transcribed verbatim, and analysed thematically. Results: 26 participants provided interviews. 8 of whom completed Photovoice activities providing additional insights. The understanding of asthma and its treatment has a significant impact on acceptance and negotiation of their identity as a person with asthma (and thence of adoption of asthma action plans). Non-acceptance to asthma diagnosis which is profound in people who were subjected to stigmatising experiences (i.e. shaming on use of inhaler in public), affects asthma control. In contrast, social support shaped a more positive understanding and experience of asthma. Conclusion: Good communication with primary care practitioners, and helping people with limited health literacy living with asthma to understand their illness better is crucial to improving self-management skills. Promoting awareness of asthma in the society may improve the level of social support and potentially lessen stigmatising experiences. Funding: HS is a PhD student with the UK NIHR Global Health Research Unit (RESPIRE).