Parental Perceptions of Barriers to Immunization among the Hmong Community in Central California.
AbstractObjectives. The Hmong community in the United States experience health inequities related to vaccine-preventable serious infectious diseases and cancers. The purpose of this study was to explore the perception of barriers to immunization among the Hmong community in Central California. Methods. In partnership with the Hmong community, a community-based participatory research study was conducted using the standardized, community-based instrument, Searching for Hardships and Obstacles to Shots. Data collection occurred in naturalistic settings. Quantitative methods including multiple regression was used to determine predictors of the perceptions of barriers to immunization. Findings. There was a total of 443 surveys used in the analysis. Ninety-three percent (93%) of the participants reported at least some barriers to immunization; 95% reported having health insurance. Four primary contributors to perceived barriers were identified: (a) selection of the Hmong language version to complete the survey, (b) income of $50,000 or less per year, and (c) use of traditional healthcare (inclusion of shamans either alone or in combination with Western healthcare), and (d) walking as the method to access healthcare. Conclusions. Negative health outcomes related to vaccine-preventable diseases persist in the Hmong community. Perceptions of barriers to immunization among the Hmong community in Central California endure, even with high rates of health insurance. Interventions aimed at reducing immunization inequities need to consider distinct sociocultural factors that impact immunization rates in this vulnerable population.