Background: Self and family management of children and young people?s (CYP) asthma is complex and multi-faceted. However, research into the impact of COVID-19 on asthma self-management from family perspectives is scant.

Aim: Provide an explanation of self and family-management beliefs and behaviours in CYP with severe or sub-optimally controlled asthma, in the context of the COVID-19 pandemic.

Methods: In-depth interviews with parents and CYP, aged 11-15 years, with asthma were analysed using grounded theory methodology.

Findings: 21 individuals (11 mothers and 10 CYP) participated.  Findings explained that families learnt how to self-manage iteratively through their experiences with asthma, alongside clinical support.  COVID-19 had multiple impacts on this learning and asthma self/family management including, highlighting CYP?s vulnerability and family understanding of asthma severity; COVID-19 fear and anxiety driving medication adherence; observation of COVID-19 infection as an asthma trigger; the apparent paradox of shielding and not being offered early vaccination; vaccination decision-making; observing improved asthma control during shielding. 

Conclusions: The study provided a unique opportunity to discuss CYP?s asthma self and family-management in the context of the changing COVID-19 restrictions.  Families described responding iteratively to changes in knowledge, anxiety, and observations of asthma control under changeable contexts.  Such contextual insight informed development of a broader explanation of family management behaviours.  These dynamic responses suggest there may be opportunities for interventions to promote self-management improvements.