Abstract
OBJECTIVE: Previously the epicenter of the COVID-19 pandemic in New York, the Bronx has one of the highest prevalence rates of pediatric asthma in the United States. Pandemic mitigation efforts altered asthma management practices in at-home and clinical settings. We were interested in identifying family caregiver-reported barriers to asthma management during the COVID-19 pandemic to optimize care for Bronx children with asthma. METHODS: To explore family caregiver perspectives about asthma management and resources needed during the COVID-19 pandemic, we conducted qualitative interviews with caregivers of children with asthma receiving care at 9 clinics in the Bronx. Caregivers were asked via telephone about the COVID-19 pandemic and how it affected the family and child's asthma management. Child demographic characteristics and asthma status were obtained from medical records and survey data. Interview notes were independently coded for common themes. Investigators agreed on emerging themes. RESULTS: 61 caregivers participated (95% female). Nearly half of caregivers reported improvement in child's asthma due to stay-at-home orders and decreased outdoor trigger exposure. Many experienced challenges accessing medical care during the pandemic. Some children were exposed to indoor triggers like secondhand smoke. Caregivers also reported challenges finding opportunities for physical activity and challenges associated with caregiver and child mental health. CONCLUSIONS: Caregivers experienced improved asthma management because of the pandemic. However, inconsistent access to care demonstrates the need for continuity of medical care and careful planning for any future stay-at-home orders. CLINICAL TRIAL: This study is registered with ClinicalTrials.gov, identifier # NCT03066596.