Adapting the Andersen Model to a Francophone West African Immigrant Population: Hepatitis B Screening and Linkage to Care in New York City
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Hepatitis B virus (HBV) is highly endemic in West Africa and immigration from this region to the United States has greatly increased over the past quarter century. Using the Andersen Model as a conceptual framework, this study qualitatively examines francophone West African immigrants’ perceptions of factors affecting access to HBV screening and linkage-to-care in New York City. Four focus groups were conducted with 39 purposefully selected participants. The focus groups were conducted in French, audio-recorded, translated into English, transcribed, analyzed, and coded for major themes. Participants identified increasing knowledge of HBV and opportunities to access care in a culturally-sensitive manner that decreases fatalism and avoids generating stigma as priorities. They also emphasized the importance of engaging religious establishments and social networks and employing the Internet to disseminate HBV-relevant information. Cost and health insurance are identified as future challenges that will need to be addressed in a health care environment in which undocumented immigrants are ineligible for health insurance. The qualitative analysis in this study highlights the recursive and interdependent nature of the Andersen Model, and a modification of the model is proposed that is intended to inform examinations of other minority communities’ access to health care.
KeywordsHepatitis B Immigration West Africa Qualitative research
This work was supported in part by a grant from the Doris Duke Charitable Foundation to the Mount Sinai School of Medicine to fund Clinical Research Fellow Demetri Blanas. This work was in part supported by a grant from the American College of Gastroenterology to fund Ponni Perumalswami, MD, MCR. This work was also supported in part by funding for the African Services Committee from the Centers for Disease Control (Grant PS12-1209PPHF12), and Gilead Sciences, Inc. (IX-US-174-0203 Grant).
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