Open AccessBarriers to accessing preventive health care among African-born individuals in King County, Washington: A qualitative study involving key informants
Author(s) -
D. Allen Roberts,
Seifu Abera,
Guiomar Basualdo,
Roxanne P. Kerani,
Farah Mohamed,
Rahel Schwartz,
Beyene Tewelde Gebreselassie,
Ahmed Ali,
Rena C Patel
Publication year - 2021
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0250800
Subject(s) - thematic analysis , health care , outreach , language barrier , medicine , psychological intervention , health equity , qualitative research , community engagement , community health , immigration , public health , nursing , gerontology , family medicine , political science , public relations , sociology , social science , law
Studies of African immigrant health in the U.S. have traditionally focused on infectious diseases. However, the rising burden of non-communicable diseases (NCDs) indicates the increasing importance of general preventive health care. As part of a series of community health events designed for African-born individuals in King County, Washington, we administered key informant interviews (KIIs) with 16 health event participants, medical professionals, and community leaders to identify barriers and facilitators to use of preventive health care among African-born individuals. We used descriptive thematic analysis to organize barriers according to the socio-ecological model. Within the individual domain, KII participants identified lack of knowledge and awareness of preventive health benefits as barriers to engagement in care. Within the interpersonal domain, language and cultural differences frequently complicated relationships with health care providers. Within the societal and policy domains, healthcare costs, lack of insurance, and structural racism were also reported as major barriers. Participants identified community outreach with culturally competent and respectful providers as key elements of interventions to improve uptake. In conclusion, African immigrant communities face several barriers, ranging from individual to policy levels, to accessing health services, resulting in substantial unmet need for chronic disease prevention and treatment. Community-centered and -led care may help facilitate uptake and engagement in care.