“if they tell me to get it, i’ll get it,” - immigrant mothers’ immunization decision-making...
TRANSCRIPT
“If They Tell Me To Get It, I’ll Get It,” - Immigrant Mothers’ Immunization Decision-Making
by Stephanie Patricia Kowal1, Dr Cindy Jardine1, and Dr Tania Bubela1
1 School of Public Health, University of AlbertaPublic Health 2014, May 27, 2014, Toronto, ON
Statistics Canada, censuses of population, 1901 to 2006.
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6
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2
1
0
millions percentage25%
20%
15%
10%
5%
0%1901 1911 1921 1931 1941 1951 1961 1971 1981 1986 1991 1996 2001 2006
Census Year
Proportion of Foreign-Born Population in Canada
Canada’s Foreign-Born Population
Canada’s Foreign-Born Population
Foreign-Born Population in Edmonton, Alberta
Edmonton: 22.9%
Alberta: 16.2%
Canada: 19.8%
Statistics Canada, censuses of population, 1901 to 2006.
Immigrant Women as a Vulnerable Population
• Barriers to health systems• Language• Economic situations
• Pregnant Women • Increased risk to infectious
disease
Health Protection through Vaccination
• Disparities among children
• Disparities among women
• Varied experiences and what this means as an immigrant?
Jenista, 2001; Meints & Chescheir, 2010; McElroy et al., 2009
Health Protection through Vaccination
• Disparities among children
• Disparities among women
• Varied experiences and what this means as an immigrant?
Jenista, 2001; Meints & Chescheir, 2010; McElroy et al., 2009
1) Understand decision making processes
2) Assess information needs
Study Purpose
1) Vaccine knowledge learned from origin countries.
2) How that knowledge applied in Canada.
3) How to develop effective risk communication.
Research Questions
Methods
23 Qualitative Interviews
South Asia: n=8
China: n=10
Bhutanese Refugees: n=5
Sample: Participating Communities
1) China-, South Asia-, or Bhutan-born2) Pregnant and/or have children under 8 years old3) Immigrated to Canada in the last 8 years4) Living in Edmonton, Alberta, Canada
Edmonton’s Foreign-Born Population
Immigrant Population Make-Up: Edmonton, Alberta
Chinese 28%
Latin American 5%
South Asian 23%South East Asian 6%
Black 12%
Arab 7%
Filipino 11%
Other 8%
Statistics Canada, censuses of population, 1901 to 2006.
Interview Guide
• Previous vaccine experiences
• Comprehension of how vaccine technology and regulations
• Vaccine information access and use
Results - Passivity
I just walked into the medi-centre and did not have much interaction with any doctor so I’m not really sure. Maybe if I had a family doctor they would have suggested vaccines. (South Asian Participant)
Results: Immunization Decision-Making Processes
I went to the doctor because I had a flu and I think because it wasn’t necessary so that was why I was not advised to take it. I didn’t ask. If my doctor tells me to take it, I will take it. But if my doctor doesn’t then... (Chinese Participant)
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They give it on paper, they give it on the phone once or twice at the beginning. I just listen to what they have to say.(South Asian Participant)
Results: Immunization Decision-Making Processes
I don’t know if the doctor will say [vaccination] is a must, but yes, if the doctor says your should get it done, you should because they are telling you for your own good. (South Asian Participant)
Results: Immunization Decision-Making Processes
Implications for Communication
Doctors’ Visits
Effective Information Delivery
Uptake of Recommendations
Implications for Communication
Back to H1N1
Implications for Communication
Example of Canadian Refugee Health Policies
Doctors’ Visits
Effective Information Delivery
Uptake of Recommendations
Must Account for Unique Information Gathering and Decision-Making to Build Effective Communication
References
Jenista J. The Immigrant, Refugee, or Internationally Adopted Child. Pediatrics in Review. 2001; (22)12: 419-429.
McElroy R, Laskin M, Jiang D, Shah R, Ray J. Rates of Rubella Immunity Among Immigrant and Non-Immigrant Pregnant Women. Journal of Obstetric Gynaecology Canada. 2009; 31(5): 409-413.
Meints L, Chescheir N. Screening for infectious diseases in pregnant, foreign-born women from multiple global areas. Journal of Reproductive Medicine, 2010; 55(9-10): 382-6.
Statistics Canada (2006) Immigration and Citizenship Highlight Tables, 2006 Census. Available at http://www12.statcan.ca/census-recensement/2006/dp-pd/hlt/97-557/Index-eng.cfm
Thank You!Questions?
AcknowledgementsMulti-Cultural Health Brokers Cooperative: Yvonne Chiu Shiva Chapagai Lydia Yip Hina Naushad Ravi Hansra Daljit Rupana
Funders:• CIHR Master’s Award• HQCA Summer Studentship• WCHRI Qualitative Core Resource• WCHRI/CUP CBR Science Shop• WCHRI Graduate Studentship• SRA International Student Travel
Award
Research Participants
Contact Info: [email protected]
TranslatorsJian WangDr Amrita Mishra
Similarities Among Differences
Chinese, Bhutanese, and Indian Contexts