BACKGROUND:
Data from the California and Los Angeles County Kindergarten Retrospective Survey reveals that 60% of African American (AA) toddlers completed their necessary immunizations by age 24 months. This level is more than 10% lower than all other ethnic groups. Studies show that culturally appropriate health services and education materials have potential to reduce racial/ethnic health disparities.

OBJECTIVE:
To develop culturally appropriate messages and materials, as identified by parental knowledge/attitudes/beliefs, which promote timely immunizations among AAs.

METHOD:
In collaboration with local community based organizations (CBOs), 12 focus groups were conducted with AA parents/guardians of AA children under age 3 in 6 zip codes with traditionally low immunization rates. Recruitment included culturally appropriate flyers strategically distributed by trained volunteers, lists from client databases, and word-of-mouth referral. Eligible participants were screened over the phone/in person. Trained AA volunteers from local CBOs facilitated the discussions. Participants received a $25 gift certificate incentive. Childcare was provided. Information collected included parental knowledge/beliefs about vaccine-preventable diseases (VPDs) and sources of health information. The groups were audiotaped and transcribed. Data subsequently were analyzed.

RESULT:
Overall, participants believed immunizations were important. Significant barriers exist that impede parents/guardians from immunizing children including: 1) concerns about vaccine safety, efficacy, and content, 2) fear of needles and feelings of helplessness when children experience pain, and 3) lack of culturally competent care. Participants indicated a need for education about VPDs, vaccine content, benefits, and side effects. Trusted sources of health information included: physicians, family, and friends. Immunization promotion materials have been developed and will be presented with final data at the conference.

CONCLUSION:
Focus groups effectively provide detailed social, cultural, and economic data and allow for community involvement in the generation of ideas and materials useful for immunization promotion.

LEARNING OBJECTIVES:
Understand how to organize and develop targeted messages appropriate for hard-to-reach audiences.