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1 School of Public Health, University of Alberta Public Health 2014, May 27, 2014, Toronto, ON

“That’s How the Nurse Did It, How She Decided Which Vaccines” . 1 School of Public Health, University of Alberta Public Health 2014, May 27, 2014, Toronto, ON. by Stephanie Patricia Kowal 1 , Dr Cindy Jardine 1 , and Dr Tania Bubela 1.

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1 School of Public Health, University of Alberta Public Health 2014, May 27, 2014, Toronto, ON

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  1. “That’s How the Nurse Did It, How She Decided Which Vaccines” 1 School of Public Health, University of AlbertaPublic Health 2014, May 27, 2014, Toronto, ON by Stephanie Patricia Kowal1, Dr Cindy Jardine1, and Dr Tania Bubela1

  2. Baker et al., 2010; Luman et al. 2005; Smith & Stevenson, 2008

  3. Study Purpose Document Vaccination Experiences Understand decision making processes

  4. Methods 23 Qualitative Interviews South Asia: n=8 China: n=10 Bhutanese Refugees: n=5

  5. Edmonton’s Foreign-Born Population Immigrant Population Make-Up: Edmonton, Alberta Other 8% Chinese 28% Filipino 11% Arab 7% Latin American 5% Black 12% South East Asian 6% South Asian 23% Statistics Canada, censuses of population, 1901 to 2006.

  6. Interview Guide • Previous vaccine experiences • Comprehension of how vaccine technology and regulations

  7. Results – Passivity and Trust No. No. No. If they say go, then I’ll just go… Canada places a high importance toward children and won’t cause any harm toward them. So because of that and they have already done research to see what is good for the children, then I’ll just go with them (Chinese Participant)

  8. Results - Trust If these vaccination are at the approval of the government and have gone through medical and scientific test and it’s safe, I don’t think it’s a problem… Over here, I feel completely secure. (Chinese Participant)

  9. Results: (un)Informed Consent Technical and Regulatory Understandings

  10. Results: (un)Informed Consent There was once that after the vaccination, he developed a fever and a second time, he had some reaction…Nothing serious and I think he is accustomed to it. He didn’t cry or fuss about it. I think it’s good. (Chinese Participant)

  11. Results: Agency It was nothing like that. On our first visit, we had gone to the nurse and she told us that if we are staying close to the baby, this is the list of vaccines we give…She asked me a few questions. It also depended on which origin you were from…I think that’s how she did it, how she decided which vaccines . (South Asian Participant)

  12. Implications for Consent

  13. Uncomfortable Issues • Meaning in Consent • Compliance vs Consent • Universality of Consent

  14. Uncomfortable Issues • Meaning in Consent • Compliance vs Consent • Universality of Consent

  15. Uncomfortable Issues • Meaning in Consent • Compliance vs Consent • Universality of Consent

  16. Information in Compliance and Consent

  17. References • Baker, D. L., Dang, M. T., Ly, M. Y., & Diaz, R. (2010). Perception of Barriers to Immunization among Parents of Hmong Origin in California, American Journal of Public Health, 100(5), 839. • Luman, E. T., Barker, L. E., McCauley, M. M., & Drews-Botsch, C. (2005). Timeliness of Childhood Immunizations: A State-Specific Analysis, American Journal of Public Health, 95(8), 1367. • Smith, P. J., & Stevenson, J. (2008). Racial/Ethnic Disparities in Vaccination Coverage by 19 Months of Age: An Evaluation of the Impact of Missing Data Resulting from Record Scattering, Statistics in Medicine 27(20), 4107-4118. • Statistics Canada (2006) Immigration and Citizenship Highlight Tables, 2006 Census. Available at http://www12.statcan.ca/census-recensement/2006/dp-pd/hlt/97-557/Index-eng.cfm

  18. Thank You!Questions? Acknowledgements Multi-Cultural Health Brokers Cooperative: Yvonne Chiu Shiva Chapagai Lydia YipHinaNaushadRavi Hansra DaljitRupana • Funders: • CIHR Master’s Award • HQCA Summer Studentship • WCHRI Qualitative Core Resource • WCHRI/CUP CBR Science Shop • WCHRI Graduate Studentship Research Participants Translators Jian WangDr. Amrita Mishra Contact Info: skowal@ualberta.ca

  19. Recommendations for Communications Development Facilitate finding family doctors Create robust information delivery network to reach those not connected with physicians

  20. Chinese, Bhutanese, and Indian Contexts Similarities Among Differences

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