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“If They Tell Me To Get It, I’ll Get It,” - Immigrant Mothers’ Immunization Decision-Making

“If They Tell Me To Get It, I’ll Get It,” - Immigrant Mothers’ Immunization Decision-Making. by Stephanie Patricia Kowal 1 , Dr Cindy Jardine 1 , and Dr Tania Bubela 1. 1 School of Public Health, University of Alberta Public Health 2014, May 27, 2014, Toronto, ON.

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“If They Tell Me To Get It, I’ll Get It,” - Immigrant Mothers’ Immunization Decision-Making

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  1. “If They Tell Me To Get It, I’ll Get It,” - Immigrant Mothers’ Immunization Decision-Making by Stephanie Patricia Kowal1, Dr Cindy Jardine1, and Dr Tania Bubela1 1 School of Public Health, University of AlbertaPublic Health 2014, May 27, 2014, Toronto, ON

  2. Canada’s Foreign-Born Population Proportion of Foreign-Born Population in Canada millions percentage 25% 20% 15% 10% 5% 0% 7 6 5 4 3 2 1 0 1901 1911 1921 1931 1941 1951 1961 1971 1981 1986 1991 1996 2001 2006 Census Year Statistics Canada, censuses of population, 1901 to 2006.

  3. Canada’s Foreign-Born Population Foreign-Born Population in Edmonton, Alberta Edmonton: 22.9% Alberta: 16.2% Canada: 19.8% Statistics Canada, censuses of population, 1901 to 2006.

  4. Immigrant Women as a Vulnerable Population • Barriers to health systems • Language • Economic situations • Pregnant Women • Increased risk to infectious disease

  5. Health Protection through Vaccination • Disparities among children • Disparities among women • Varied experiences and what this means as an immigrant? • Jenista, 2001; Meints&Chescheir, 2010; McElroy et al., 2009

  6. Health Protection through Vaccination • Disparities among children • Disparities among women • Varied experiences and what this means as an immigrant? • Jenista, 2001; Meints&Chescheir, 2010; McElroy et al., 2009

  7. Study Purpose 1) Understand decision making processes 2) Assess information needs

  8. Research Questions Vaccine knowledge learned from origin countries. How that knowledge applied in Canada. How to develop effective risk communication.

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

  10. Sample: Participating Communities China-, South Asia-, or Bhutan-born Pregnant and/or have children under 8 years old Immigrated to Canada in the last 8 years Living in Edmonton, Alberta, Canada

  11. 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.

  12. Interview Guide • Previous vaccine experiences • Comprehension of how vaccine technology and regulations • Vaccine information access and use

  13. Results - Passivity I just walked into the medi-centre and did not have much interaction with any doctor so I’m not really sure. Maybe if I had a family doctor they would have suggested vaccines. (South Asian Participant)

  14. Results: Immunization Decision-Making Processes I went to the doctor because I had a flu and I think because it wasn’t necessary so that was why I was not advised to take it. I didn’t ask. If my doctor tells me to take it, I will take it. But if my doctor doesn’t then... (Chinese Participant) 30

  15. Results: Immunization Decision-Making Processes They give it on paper, they give it on the phone once or twice at the beginning. I just listen to what they have to say. (South Asian Participant)

  16. Results: Immunization Decision-Making Processes I don’t know if the doctor will say [vaccination] is a must, but yes, if the doctor says your should get it done, you should because they are telling you for your own good. (South Asian Participant)

  17. Implications for Communication Doctors’ Visits Effective Information Delivery Uptake of Recommendations

  18. Implications for Communication Back to H1N1

  19. Implications for Communication Example of Canadian Refugee Health Policies Doctors’ Visits Effective Information Delivery Uptake of Recommendations

  20. Must Account for Unique Information Gathering and Decision-Making to Build Effective Communication

  21. References • Jenista J. The Immigrant, Refugee, or Internationally Adopted Child. Pediatrics in Review. 2001; (22)12: 419-429. • McElroy R, Laskin M, Jiang D, Shah R, Ray J. Rates of Rubella Immunity Among Immigrant and • Non-Immigrant Pregnant Women. Journal of Obstetric Gynaecology Canada. 2009; • 31(5): 409-413. • Meints L, Chescheir N. Screening for infectious diseases in pregnant, foreign-born women from multiple global areas. Journal of Reproductive Medicine, 2010; 55(9-10): 382-6. • 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

  22. 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 • SRA International Student Travel Award Research Participants Translators Jian WangDr Amrita Mishra Contact Info: skowal@ualberta.ca

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

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