Embed Size (px)
Citation preview
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
“That’s How the Nurse Did It, How She Decided Which Vaccines”
Baker et al., 2010; Luman et al. 2005; Smith & Stevenson, 2008
1) Document Vaccination Experiences
2) Understand decision making processes
Study Purpose
Methods
23 Qualitative Interviews
South Asia: n=8
China: n=10
Bhutanese Refugees: n=5
Edmonton’s Foreign-Born Population
Immigrant Population Make-Up: Edmonton, Alberta
Chinese 28%
Latin American 5%
South Asian 23%South East Asian 6%
Black 12%
Arab 7%
Filipino 11%
Other 8%
Statistics Canada, censuses of population, 1901 to 2006.
Interview Guide
• Previous vaccine experiences
• Comprehension of how vaccine technology and regulations
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)
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)
Results: (un)Informed Consent
Technical and Regulatory Understandings
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)
Results: (un)Informed Consent
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)
Results: Agency
Implications for Consent
Uncomfortable Issues
• Meaning in Consent
• Compliance vs Consent
• Universality of Consent
Uncomfortable Issues
• Meaning in Consent
• Compliance vs Consent
• Universality of Consent
Uncomfortable Issues
• Meaning in Consent
• Compliance vs Consent
• Universality of Consent
Information in Compliance and Consent
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
Thank You!Questions?
AcknowledgementsMulti-Cultural Health Brokers Cooperative: Yvonne Chiu Shiva Chapagai Lydia Yip Hina Naushad Ravi Hansra Daljit Rupana
Funders:• CIHR Master’s Award• HQCA Summer Studentship• WCHRI Qualitative Core Resource• WCHRI/CUP CBR Science Shop• WCHRI Graduate Studentship
Research Participants
Contact Info: [email protected]
TranslatorsJian WangDr. Amrita Mishra
Recommendations for Communications Development
1) Facilitate finding family doctors
2) Create robust information delivery network to reach those not connected with physicians
Similarities Among Differences
Chinese, Bhutanese, and Indian Contexts
