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Identifying Immunization Barriers Among Asian American Children: Results and Recommendations Asian Health Coalition of I

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 Recommendations Asian Health Coalition of I

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

  2. IBAAC Project-Funding • 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

  3. Asian Health Coalition of Illinois • Mission: To improve the health and well-being of Asian Americans and Pacific Islander (AAPIs) in Illinois.

  4. Asian Health Coalition • 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

  5. AHCI Programs • Cultural competence training • HIV prevention capacity-building assistance • Tobacco control (cessation and prevention/awareness) • Childhood immunization • Annual conference • Quarterly membership meetings • Information, Referral, Listserve

  6. IBAAC-Background • 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

  7. AAPI Population Percent Increase in 6 Illinois Counties, 1990-2000

  8. Who are AAPIs in Illinois? (1 of 2)

  9. Who are AAPIs in Illinois? (2 of 2)

  10. Access to Care:Percentage of Uninsured AAPIs (2001) Source: The Commonwealth Fund

  11. IBAAC Project-Advisory Committee • 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

  12. IBAAC-Partner Agencies • Cambodian Association of Illinois • Chinese American Service League • Indo-American Center • Korean American Community Services • Lao American Community Services • Vietnamese Association of Illinois

  13. IBAAC Project Methods • Focus group format • Trained bilingual bicultural moderators • Audiotaped proceedings transcribed into English • Written summary report

  14. Participants • N=67 [Range 7-15] • Participants received a $25 stipend • Discussion centered on 6 questions

  15. Focus Groups Questions 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?

  16. Focus Group Questions 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?

  17. IBAAC Results

  18. Demographics • All participants were foreign born • Only 8% identified English as their primary language • 97% reported having a primary care provider for their child

  19. Health Insurance Status • Insured 90% • Medicaid 36% • KidCare 22% • Private Insurance 31% • Uninsured 10%

  20. Communication with Provider • 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

  21. Perceptions of Immunizations • 71% reported being “very” concerned about the effects of childhood diseases

  22. Identified Barriers • Cost • Language • Information and Records • Appointments • Provider Choice

  23. Cost • Some participants mentioned that they paid as much as $50-$60 for each immunization • Many participants were unaware of how to access free immunizations

  24. Language • Many participants stated that they had great difficulty communicating with their doctors • Many participants reported difficulty understanding written material

  25. Information and Records • 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

  26. Appointments • Difficulty in scheduling appointments • Wait-times up to 2 hrs to see doctors • Walk in appointments • Scheduled appointments

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

  28. Recommendations • 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

  29. As a result…steps taken:

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

  31. Increase Accessto Immunizations • AA community-based organizations can schedule and promote mobile immunization clinics • CDPH CareVan • Identify other sources of free immunization services

  32. Increase Awareness of Free Immunization Services • 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

  33. Decrease Language Barriers • 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 www.immunize.org • Consider audiotapes and videotapes as a means of reaching populations with low literacy

  34. Decrease Language Barriers • CDPH, CAIC and AA community based organizations • Increase awareness of existing translated immunization education materials such as the VISs available from www.immunize.org • Translate Vaccine Information Statements into additional languages (Hindi and Urdu) • Translate school immunization requirements

  35. Provide Immunization Education Materials to AA Communities • 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

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