Department of Epidemiology, University of Washington, Seattle, Washington, United States of America.
Department of Medicine, University of Washington, Seattle, Washington, United States of America.
PLoS One. 2021 May 10;16(5):e0250800. doi: 10.1371/journal.pone.0250800. eCollection 2021.
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.
美国的非洲移民健康研究传统上侧重于传染病。然而，非传染性疾病（NCDs）负担的增加表明一般预防保健的重要性日益增加。作为华盛顿金县为非洲出生的个人设计的一系列社区健康活动的一部分，我们对 16 名健康活动参与者、医疗专业人员和社区领袖进行了关键知情人访谈（KII），以确定非洲出生的个人使用预防保健的障碍和促进因素。我们使用描述性主题分析根据社会生态模型组织障碍。在个体领域，KII 参与者确定缺乏对预防保健益处的知识和认识是参与护理的障碍。在人际领域，语言和文化差异经常使与医疗保健提供者的关系复杂化。在社会和政策领域，医疗保健费用、缺乏保险和结构性种族主义也被报告为主要障碍。参与者确定以具有文化能力和尊重的提供者进行社区外展是改善参与度的干预措施的关键要素。总之，非洲移民社区在获得医疗服务方面面临着从个人到政策层面的诸多障碍，导致慢性病预防和治疗的巨大需求未得到满足。以社区为中心和以社区为导向的护理可能有助于促进参与和参与护理。
