Cultural Beliefs and Attitudes about Immunizations in a Diverse Urban Pediatric Population
Dawn L. Martin, Lisa LaForest, Tu Quan, and Joni Geppert. Department of Pediatrics, Hennepin County Medical Center, 701 Park Ave South, Minneapolis, MN, USA
Learning Objectives for this Presentation: By the end of the presentation participants will be able to: 1) Become familiar with immunization cultural beliefs/attitudes of Hispanic, Somali and African American families. 2) Apply study results to culturally appropriate educational methods/outreach.
Background: Aggressive immunization initiatives have resulted in significant improvements in immunization coverage (80.9% coverage for 19-35 month olds, 4:3:1:3:3, 2005). Many of these improvements can be attributed to reducing health system/provider barriers to immunization delivery. Family related factors also influence immunization coverage; however, the independent effects of specific cultural beliefs/ attitudes toward immunizations are difficult to isolate and have not been well studied. Understanding these factors is important given the increasingly diverse pediatric population.
Setting: Ambulatory pediatric clinic, Hennepin County Medical Center (HCMC), Minneapolis, Minnesota
Population: Hispanic, Somali and African American families, with 6-36 month olds, seeking medical care at HCMC pediatric clinic
Project Description: Stratified sample of 300 families were interviewed (99 Somali, 137 Hispanic, 64 African American) by trained, native speakers regarding demographics, immunization knowledge, beliefs, and practices from 11/2003 to 11/2005.
Results/Lessons Learned: Families viewed immunizations positively, 99% reported immunizations are an accepted/important part of health in their culture. Absence of fear was notable, 91.5% believe vaccines never do more harm than good; no neurodevelopmental concerns were noted. Knowledge gaps were identified; fever (23.5%) and cold (53.0%) were reported as contraindications. Vaccine protection against colds (54.4%), diarrhea (24.4%), and HIV (23.1%) were reported; 59.5% believed immunizations cured Hepatitis B, meningitis, measles or polio. African Americans (78.4%) are less likely to believe if their child is not immunized that s/he will get the disease (p=0.021) compared with Hispanics (91.2%) and Somali (93.1%). Hispanics (82.1%) are most likely to believe immunizations will always prevent disease (p=0.001) compared with African Americans (5.5%) and Somali (1.4%). Improved knowledge and understanding provides the basis for more culturally appropriate outreach programs/patient education.