Health literacy and asthma management among African-American adults: an interpretative phenomenological analysis

Objective: African-Americans share a disproportionate burden of asthma and low health literacy and have higher asthma morbidity and mortality. Factors that link the relationship between health literacy and health outcomes are unclear. This study aimed to use patients' experiences of managing asthma to better understand the relationship between health literacy and health outcomes. Methods: This study was the qualitative component of a mixed methods study. Following quantitative data collection, four participants, two with low print-related health literacy and two with adequate print-related health literacy, completed semi-structured interviews. Interview data were analyzed using interpretative phenomenological analysis. Results: Three themes emerged from the analysis: information desired versus information received, trial and error, and expectations of the patient-provider relationship. Individuals with adequate print-related health literacy had different strategies for overcoming barriers related to communicating with their providers, learning about their disease and experiences of discrimination within the healthcare system. Conclusions: Individuals with adequate print-related health literacy may be more equipped to participate in shared decision making and feel more confident to successfully manage their disease. It is also important that health literacy is discussed in the context of the cultural and racial background of the population of interest. This interdependent relationship between health literacy and culture is particularly important for African-Americans.