312803
An examination of attitudes, beliefs and behaviors related to vaccination and testing practices for seasonal influenza and viral hepatitis B & C in Native American populations residing in Indiana
Methods Purposeful sampling was conducted—59 men and women, self-identified as Native American, were recruited from Pow wows held in Indiana from 9/21/13 to 1/4/14. Open-ended interviews were conducted, along with demographic & vaccination survey. Interviews were audio recorded. Important areas explored: identity and cultural influences and health; understanding of influenza and hepatitis B vaccination, and Hepatitis C testing; & confidence in healthcare.
Results Fifty nine individuals were enrolled in study (male=23, female 30, two spirit =6). Participants ages were 19-75 years. Participants reported 20 different tribal affiliations. Participants reported 42% (25) receiving flu vaccination within 12 months. This number is similar to national 2011-2012 influenza vaccination rate for NA. Chi square tests conducted for gender found no difference between males and females in influenza vaccination, Hepatitis B vaccination or Hepatitis C testing.
Three major themes emerged: Community as part of health; perceptions of trust-vs-mistrust in healthcare; knowledge deficits regarding hepatitis B & C. With analysis of interview findings 75% of participants voiced the Native American community as important to life and health. The impact of trust vs mistrust of healthcare vaccination practices & providers was a 2nd major theme with 35% relating statements of mistrust of health care services. The third major theme noted was lack of knowledge and understanding about Hepatitis B & C. A significant proportion expressed lack of understanding or knowledge regarding CDC initiative to initiate Hepatitis C testing.
Conclusions Despite public information related to safety and efficacy of seasonal influenza & Hepatitis B vaccination, mistrust still exists. A significant proportion of participants interviewed had little knowledge about Hepatitis C testing. Providers should be aware of the possibility of trust and access issues with members of Native American community related to health care & utilize an approach that demonstrates respect for Native American beliefs.
Learning Areas:
Administer health education strategies, interventions and programsAdvocacy for health and health education
Diversity and culture
Planning of health education strategies, interventions, and programs
Provision of health care to the public
Public health or related public policy
Learning Objectives:
Describe attitudes, beliefs, and behaviors of a sample of Native Americans related to vaccinations
Keyword(s): Native Americans, Immunizations
Qualified on the content I am responsible for because: Experience with primary care as a nurse practitioner including immunizations, as a health educator, instructor, and researcher including surgery methods.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.