Background: The Hmong, formerly from the highland plains of Laos, arrived in the U.S. as refugees after Vietnam-American War. In 2004, another significant surge occurred when the Hmong held in Thailand camps were reclassified as refugees and permitted to enter the U.S. This more recent group of Hmong refugees presented with unique health needs, related to their long internment, that included the need for immunizations. Hmong refugees were under immunized in the camps and upon entrance to the U.S. were provided with one dose [first dose] of multiple vaccinations, and many remain under immunized. Regardless of length-of-time in the U.S., the Hmong continue to experience significant health inequities that include vaccine-preventable cancers and infections. A study conducted in 2009 found that when the Hmong include a complementary and alternative healthcare provider (CAHP) (e.g. shaman) as a source of healthcare they perceive significantly more barriers to immunizations.
Setting: Various refugee communities with significant use of complementary and alternative healthcare providers
Population: Communities of Hmong origin and other Asian communities
Project Description: Community based participatory research (CBPR) partnerships are an effective mechanism to empower communities to address inequities; in addition, social marketing campaigns demonstrate effectiveness in reaching hard-to-reach communities. However, there is limited information about how to include CAHPs, such as Hmong shaman, in social marketing efforts. Our CBPR partnership instigated an immunization campaign which included endorsement by Hmong shaman partnered with Western medical doctors of Hmong origin, to address immunization inequities.
Results/Lessons Learned: Social marketing campaigns require significant time to create the prerequisite trust required to include CAHPs, develop culturally responsive campaign materials, and link the campaign with effective channels of communication. CBPR partnerships provide an effective mechanism to work with the Hmong community to reduce immunization inequities.