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Identifying Immunization Barriers Among Asian American Children: Results and Recommendations Asian Health Coalition of Illinois May 13, 2004. IBAAC Project-Funding. Funded by the American Academy of Pediatrics Funded through the CATCH Program [Community Access to Child Health]

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Identifying Immunization Barriers Among Asian American Children:Results and RecommendationsAsian Health Coalition of IllinoisMay 13, 2004

Ibaac project funding
IBAAC Project-Funding Children:

  • Funded by the American Academy of Pediatrics

  • Funded through the CATCH Program

    [Community Access to Child Health]

  • CATCH is the area in the AAP that highlights care of children in their respective communities

Asian health coalition of illinois
Asian Health Coalition of Illinois Children:

  • Mission:

    To improve the health and well-being of

    Asian Americans and Pacific Islander

    (AAPIs) in Illinois.

Asian health coalition
Asian Health Coalition Children:

  • Areas of work:

    Advocacy, technical assistance, education,

    and community-based research

  • Members:

    Health care providers, community-based organizations, social service providers, public health departments, researchers, students

Ahci programs
AHCI Programs Children:

  • Cultural competence training

  • HIV prevention capacity-building assistance

  • Tobacco control (cessation and prevention/awareness)

  • Childhood immunization

  • Annual conference

  • Quarterly membership meetings

  • Information, Referral, Listserve

Ibaac background
IBAAC-Background Children:

  • Project developed in 2000 in response to data indicating a downward trend in immunization rates among Asian American children

  • Project conducted focus groups in 6 Chicago Asian communities

Access to care percentage of uninsured aapis 2001
Access to Care: 1990-2000Percentage of Uninsured AAPIs (2001)

Source: The Commonwealth Fund

Ibaac project advisory committee
IBAAC Project-Advisory Committee 1990-2000

  • Principal Investigator:

    Dennis L. Vickers,MD,MPH IWS

  • Committee Members/ Agencies:

    • Fred Kviz, Ph.D UIC SPH

    • Hong Liu, Ph.D IHEC

    • Julie Morita, MD CDPH

    • Joanna Su,MSW AHCI

    • Virginia Warren,RN,MPH IHEC

  • Student Interns:

    • Richa Aggarwal

    • Michelle Choi,RN,MSN

Ibaac partner agencies
IBAAC-Partner Agencies 1990-2000

  • Cambodian Association of Illinois

  • Chinese American Service League

  • Indo-American Center

  • Korean American Community Services

  • Lao American Community Services

  • Vietnamese Association of Illinois

Ibaac project methods
IBAAC Project Methods 1990-2000

  • Focus group format

    • Trained bilingual bicultural moderators

    • Audiotaped proceedings transcribed

      into English

  • Written summary report

Participants 1990-2000

  • N=67 [Range 7-15]

  • Participants received a $25 stipend

  • Discussion centered on 6 questions

Focus groups questions
Focus Groups Questions 1990-2000

1. What are the good or positive things that come to mind when you think about childhood immunizations?

2. What are the things about childhood immunization that you think are not so good?

3. What problems have you experienced in getting your child immunized?

Focus group questions
Focus Group Questions 1990-2000

4. When you take your children to get immunizations, what problems have you had in communicating with your children’s health care provider?

5. Do you have any concerns, problems, or questions about childhood immunizations?

6. What suggestions do you have that might solve the problems that we have talked about today?

Ibaac results

IBAAC Results 1990-2000

Demographics 1990-2000

  • All participants were foreign born

  • Only 8% identified English as their primary language

  • 97% reported having a primary care provider for their child

Health insurance status
Health Insurance Status 1990-2000

  • Insured 90%

    • Medicaid 36%

    • KidCare 22%

    • Private Insurance 31%

  • Uninsured 10%

Communication with provider
Communication with Provider 1990-2000

  • 48% reported speaking to their provider in their native language

  • 26% reported speaking English to their provider

  • 17% reported using a friend or relative as an interpreter

Perceptions of immunizations
Perceptions of Immunizations 1990-2000

  • 71% reported being “very” concerned about the effects of childhood diseases

Identified barriers
Identified Barriers 1990-2000

  • Cost

  • Language

  • Information and Records

  • Appointments

  • Provider Choice

Cost 1990-2000

  • Some participants mentioned that they paid as much as $50-$60 for each immunization

  • Many participants were unaware of how to access free immunizations

Language 1990-2000

  • Many participants stated that they had great difficulty communicating with their doctors

  • Many participants reported difficulty understanding written material

Information and records
Information and Records 1990-2000

  • Doctors do not provide an explanation of the immunizations that children are receiving

  • Immunization records are confusing

  • Concerned that physicians do not have up to date records

Appointments 1990-2000

  • Difficulty in scheduling appointments

  • Wait-times up to 2 hrs to see doctors

    • Walk in appointments

    • Scheduled appointments

Provider choice
Provider Choice 1990-2000

  • Some participants complained that it was difficult to know which doctors are providing quality care

Recommendations 1990-2000

  • Increase access to free immunization services

  • Increase awareness of existing free immunization services

  • Decrease language barriers

  • Provide effective immunization materials to limited English proficient communities

  • Educate communities about provider choice

As a result steps taken
As a result… 1990-2000steps taken:

First step
First Step 1990-2000

  • Increase Asian American (AA) community based organizations, Public Health, Illinois Chapter of the American Academy of Pediatrics and Chicago Area Immunization Campaign (CAIC) collaborations

Increase access to immunizations
Increase Access 1990-2000to Immunizations

  • AA community-based organizations can schedule and promote mobile immunization clinics

    • CDPH CareVan

  • Identify other sources of free immunization services

Increase awareness of free immunization services
Increase Awareness of Free Immunization Services 1990-2000

  • CDPH and CAIC can provide materials to AA community-based organizations

    • Increase awareness of existing free immunization programs

      • Vaccines for Children’s Program

      • CDPH Fasttrack clinics

      • CDPH Neighborhood Health Centers

  • CDPH, CAIC and AA community-based organizations can work with ethnic media as a vehicle for disseminating information on free immunization services

Decrease language barriers
Decrease Language Barriers 1990-2000

  • CDPH and ICAAP can educate providers

    • Obligation to offer interpretation services to limited English proficient patients

    • Provide interpretation resources to providers

    • Availability of translated immunization education materials such as Vaccine Information Statements (VIS) available from

    • Consider audiotapes and videotapes as a means of reaching populations with low literacy

Decrease language barriers1
Decrease Language Barriers 1990-2000

  • CDPH, CAIC and AA community based organizations

    • Increase awareness of existing translated immunization education materials such as the VISs available from

    • Translate Vaccine Information Statements into additional languages (Hindi and Urdu)

    • Translate school immunization requirements

Provide immunization education materials to aa communities
Provide Immunization Education Materials to AA Communities 1990-2000

  • CDPH, CAIC, and AA community organizations will develop a community education curriculum and materials

    • Overview of disease and immunizations

    • Explanation of the childhood immunization records

    • Encourage AA parents to ask questions of their providers

    • Provide ways of evaluating and selecting health care providers