Background. Engaging populations who have been historically underrepresented in biomedical research (UBR) in intervention development can increase the diversity of trial participants and enhance the tailoring of interventions to improve clinical outcomes in populations experiencing disparities. Aims. To understand preferences for an asthma management decision-making intervention in low-income, racially, and ethnically diverse adults in safety-net primary care practices. Methods. We conducted six focus groups with UBR adults with asthma; an interview guide directed questions. An interdisciplinary team performed content analysis and used an iterative coding process to inform subsequent analysis. Results. Thirty-four individuals (100% self-reported Black race and 18% Hispanic ethnicity; 71% female; mean age 49±15, 58% with uncontrolled asthma as measured by the Asthma Control Questionnaire) were recruited from four safety-net primary care practices in New York and New Jersey. Four themes were identified from analysis of the focus group transcripts: 1) interactions that patients desire with clinicians and clinic staff; 2) preferences for asthma management decision making; 3) current asthma management strategies; and 4) (dis)trust in providers and treatment.Conclusions. This important pre-implementation data, in combination with intra- and post-trial assessments, provides comprehensive implementation metrics to consider when planning trials in safety-net primary care sites. Such community-informed research may increase recruitment of diverse participants to clinical trials and identify intervention targets that matter most to the community.