Assessing Context to Inform Cultural Tailoring of a School-Based Asthma Program for Dissemination to Rural Colorado

School-based asthma programs have reduced asthma disparities for low-income and racial/ethnic minority children in urban settings, including Latinx families. However, rural parent perspectives have not yet been incorporated into these programs. To inform implementation of our Better Asthma Control for Kids (BACK) program in rural Colorado, we sought to understand the barriers and facilitators to asthma management in rural settings for Latinx and non-Latinx families. Between June and September 2022, interviews with Latinx and non-Latinx caregivers of children with asthma in rural Colorado explored barriers and facilitators to pediatric asthma management, including self-management practices, cultural beliefs, and interest in BACK. Interviews were coded and analyzed for thematic domains of commonalities and unique experiences by ethnicity/language spoken. We interviewed 22 caregivers (68% Latinx, 45% Spanish-speaking) living in two rural regions of Colorado. Barriers across caregivers included three themes: (a) Rural families experience challenges accessing asthma care due to transportation challenges and limited health care availability. (b) Families have common knowledge, language, and cultural gaps that lead to misperceptions of asthma. Latinx caregivers, who often struggled to understand why their child had asthma, leading to limited diagnosis acceptance and obstacles to self-management. (c) Rural caregivers desire tailored education to address asthma knowledge gaps and were interested in school-based asthma programs like BACK. The novel barriers to pediatric asthma management identified among rural non-Latinx and Latinx families will guide tailoring of BACK to enhance its impact—other programs seeking to improve asthma disparities in rural and Latinx communities should consider these barriers.