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Aidoo-Frimpong G, Turner D, Collins RL, Ajiboye W, Agbemenu K, Nelson LE. WhatsApp-propriate? Exploring "WhatsApp" as a Tool for Research Among Ghanaian Immigrants in the United States. J Racial Ethn Health Disparities 2024; 11:1956-1963. [PMID: 37285049 PMCID: PMC10246539 DOI: 10.1007/s40615-023-01664-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/19/2023] [Accepted: 05/24/2023] [Indexed: 06/08/2023]
Abstract
African immigrants remain underrepresented in research due to challenges in recruitment. Mobile instant messaging applications, such as WhatsApp, present novel, and cost-effective opportunities for conducting health research across geographic and temporal distances, potentially mitigating the challenges of maintaining contact and engagement in research with migrant populations. Moreover, WhatsApp has been found to be commonly used by African immigrant communities. However, little is known about the acceptability and use of WhatsApp as a tool for health research among African immigrants in the US. In this study, we examine the acceptability and feasibility of WhatsApp as a tool for research among Ghanaian immigrants- a subset of the African immigrant population group. We used WhatsApp to recruit 40 participants for a qualitative interview about their use of the mobile messaging application. Three distinct themes related to the acceptability and feasibility of WhatsApp emerged from the interviews: (1) preference for using WhatsApp as a medium of communication; (2) positive perception of WhatsApp; and (3) preference for using WhatsApp for research. The findings indicate that for African immigrants in the US, WhatsApp is a preferred method for recruiting and collecting data. It remains a promising strategy to utilize in future research involving this population.
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Affiliation(s)
- Gloria Aidoo-Frimpong
- Center for Interdisciplinary Research on AIDS, School of Public Health, Yale University, New Haven, CT, USA.
| | - DeAnne Turner
- College of Nursing, University of South Florida, Tampa, FL, USA
| | - R Lorraine Collins
- School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Wale Ajiboye
- MAP Center for Urban Health Solution, Unity Health Toronto - St Michael's Hospital, Ontario, Canada
| | - Kafuli Agbemenu
- School of Nursing, University at Buffalo, State University of New York, Buffalo, NY, USA
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2
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Koku EF. The Effect of Stigma and Social Networks on Role Expectations among African Immigrants Living with HIV. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:782. [PMID: 38929028 PMCID: PMC11204145 DOI: 10.3390/ijerph21060782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 06/06/2024] [Accepted: 06/11/2024] [Indexed: 06/28/2024]
Abstract
This paper examines how African immigrants living with HIV negotiate and reconstruct their productive (i.e., educational and career opportunities), sexual, and reproductive identities. We used data from a mixed-methods study to explore how stigma and social networks in which participants were embedded shaped how they understood and negotiated their role expectations and responsibilities. Participants revealed how HIV not only changed their identities and limited their sex life, partner choices, and fundamental decisions about fertility and reproduction, but also presented them with the opportunity to reinvent/reshape their lives. Our analysis revealed that the cultural discourses about illness and HIV in participant's countries of origin, the acculturative and migratory stressors, and the competing influences and expectations from family and friends in their home and host countries shape their illness experience, and how they adjust to life with HIV. This paper builds on sociological understanding of illness experience as a social construct that shapes the ill person's identity, role, and function in society. Specifically, the paper contributes to discourses on how (i) participants' social location and identity (as transnational migrants adjusting to acculturative stressors associated with resettlement into a new country), (ii) cultural discourses about illness and HIV in their countries of origin, and (iii) embeddedness in transnational social networks influence health outcomes, including lived experiences with chronic illnesses and stigmatized conditions such as HIV.
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Affiliation(s)
- Emmanuel F Koku
- Department of Sociology, Drexel University, 3201 Arch Street, Room 288, Philadelphia, PA 19104, USA
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3
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Elmileik E, Turnbull I. Impact of HIV/AIDS on African-born Women Living in the United States: a Systematic Review. J Racial Ethn Health Disparities 2023; 10:680-707. [PMID: 35132608 DOI: 10.1007/s40615-022-01256-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 01/25/2022] [Accepted: 01/31/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND There is paucity of surveillance data about African-born women (ABW) living with HIV/AIDS in the USA. Out of the 50 US states, only Washington state and Minnesota report HIV surveillance data about African-born people, and Minnesota is the only state that reports data about ABW, specifically. In Minnesota, ABW have the largest prevalence rate of HIV/AIDS among all women. In Washington state, foreign-born Black people have the highest incidence of HIV behind white people and foreign-born Hispanic people. This study aims to better understand the impact HIV/AIDS on ABW. METHODS This systematic review is based on articles available on three databases (PubMed, Embase, and Cochrane Library). Databases were searched for articles that included quantitative and/or qualitative findings about the impact of HIV/AIDS on ABW in the USA. RESULTS Several themes were identified including disproportionate impact of HIV/AIDS on ABW, barriers to care, low sexual health knowledge, HIV-related stigma, and limited HIV testing. Based on 2013 data, the incidence of HIV among ABW was 12 times higher than the incidence among women in the general US population. In 2008-2014, ABW had the smallest decline in HIV diagnosis rate when compared to US-born men and women, African-born men, and Caribbean-born men and women. Barriers that ABW face when trying to access care include, language barriers, fear of deportation and difficulty navigating the US healthcare system. CONCLUSION ABW living in the USA are uniquely impacted by HIV/AIDS. Lasting negative health consequences can be mitigated by improving HIV surveillance and investing in further studies about this population.
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Affiliation(s)
- Eiman Elmileik
- Michigan State University College of Human Medicine, East Lansing, MI, USA.
| | - Ivy Turnbull
- AIDS Alliance for Women, Infants, Children, Youth & Families, Washington, D.C., WA, USA
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Kerani RP, Lugg A, Berzins B, Gaye O, Lipira LE, Bundy C, Kwakwa H, Holmes KK, Golden MR. Post-migration HIV acquisition among african immigrants in the U.S. J Immigr Minor Health 2022; 24:1459-1468. [PMID: 35415766 PMCID: PMC9554041 DOI: 10.1007/s10903-022-01356-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 03/10/2022] [Accepted: 03/14/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND African immigrants in the U.S. are more likely to have a late HIV diagnosis than U.S.-born people, potentially leading to onward transmission. We sought to determine the proportion of African-born people living with HIV (APLWH) who (1) had tested HIV negative prior to diagnosis, and (2) likely acquired HIV in the U.S. METHODS We interviewed APLWH from 2014 to 2017 and estimated the proportion with post-migration HIV acquisition based on clinical data, HIV testing history, immigration date, and behavioral data. RESULTS Of 179 participants, 113 (63%) were women. Less than half (44%) reported a negative HIV test prior to diagnosis. Among 142 (79%) participants with sufficient data to evaluate post-migration HIV acquisition, we estimate that 29% acquired HIV post-migration. Most APLWH acquire HIV prior to immigration. DISCUSSION Approximately one-quarter of APLWH acquire HIV post-migration and HIV testing is infrequent, highlighting the need for prevention efforts for African immigrants in the U.S.
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Affiliation(s)
- Roxanne P Kerani
- Department of Medicine, University of Washington, Seattle, WA, United States.
- HIV/STD Program, Public Health - Seattle and King County, Seattle, WA, United States.
- Department of Epidemiology, University of Washington, Seattle, WA, United States.
- Center for AIDS and STD, Harborview Medical Center, 325 9th Ave, Box 359932, 98104, Seattle, WA, United States.
| | - Amanda Lugg
- African Services Committee, New York, NY, United States
| | - Baiba Berzins
- Division of Infectious Diseases, Northwestern University, Evanston, IL, United States
| | - Oumar Gaye
- Philadelphia Department of Public Health, Philadelphia, PA, United States
| | - Lauren E Lipira
- Department of Health Services, University of Washington, Seattle, WA , United States
- Oregon Health Authority and the Regional Research Institute, Portland State University, Portland, OR, United States
| | - Camille Bundy
- Division of Infectious Diseases, Northwestern University, Evanston, IL, United States
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, United States
| | - Helena Kwakwa
- Philadelphia Department of Public Health, Philadelphia, PA, United States
| | - King K Holmes
- Department of Medicine, University of Washington, Seattle, WA, United States
- Department of Epidemiology, University of Washington, Seattle, WA, United States
- Department of Global Health, University of Washington, Seattle, WA, United States
| | - Matthew R Golden
- Department of Medicine, University of Washington, Seattle, WA, United States
- HIV/STD Program, Public Health - Seattle and King County, Seattle, WA, United States
- Department of Epidemiology, University of Washington, Seattle, WA, United States
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5
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Nkimbeng M, Rosebush CE, Akosah KO, Yam H, Russell WN, Bustamante G, Albers EA, Shippee TP, Sasikumar AP, Gaugler JE. The Immigrant Memory Collaborative: A Community-University Partnership to Assess African Immigrant Families' Experiences with Dementia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074075. [PMID: 35409758 PMCID: PMC8997896 DOI: 10.3390/ijerph19074075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 03/07/2022] [Accepted: 03/22/2022] [Indexed: 12/04/2022]
Abstract
Research suggests a disparity in the prevalence of dementia, with Black older adults having double the risk compared to their White counterparts. African immigrants are a fast-growing segment of the U.S. Black population, but the dementia care needs and resources of this population are not fully understood. In this paper, we describe the process of working collaboratively with a community partner and project advisory board to conduct a culturally informed project. Specifically, we describe the process of developing culturally informed instruments to collect data on dementia care needs and resources among African immigrants. Working together with a diverse project advisory board, a guide was developed and used to conduct community conversations about experiences with dementia/memory loss. Transcripts from six conversations with 24 total participants were transcribed and analyzed thematically by two independent coders in Nvivo. These qualitative findings were used to inform the development of a survey for quantitative data collection that is currently ongoing. Themes (e.g., cultural attitudes, challenges, and current resources) from the community conversations that informed the survey are described briefly. Despite the challenges of conducting research during a global pandemic, having trusting relationships with a partnering community organization and project advisory board facilitated the successful development of instruments to conduct preliminary dementia care research in an underserved population. We anticipate that survey results will inform interventions that increase education, outreach, and access to dementia care and caregiving resources for this population. It may serve as a model for community–university partnerships for similar public health efforts in dementia as well as other chronic disease contexts.
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Affiliation(s)
- Manka Nkimbeng
- Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN 55455, USA; (C.E.R.); (K.O.A.); (H.Y.); (E.A.A.); (T.P.S.); (J.E.G.)
- Correspondence:
| | - Christina E. Rosebush
- Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN 55455, USA; (C.E.R.); (K.O.A.); (H.Y.); (E.A.A.); (T.P.S.); (J.E.G.)
| | - Kwame O. Akosah
- Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN 55455, USA; (C.E.R.); (K.O.A.); (H.Y.); (E.A.A.); (T.P.S.); (J.E.G.)
| | - Hawking Yam
- Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN 55455, USA; (C.E.R.); (K.O.A.); (H.Y.); (E.A.A.); (T.P.S.); (J.E.G.)
| | - Wynfred N. Russell
- African Career Education and Resources Inc., Brooklyn Park, MN 55445, USA; (W.N.R.); (A.P.S.)
| | - Gabriela Bustamante
- Program in Health Disparities Research, Department of Family Medicine & Community Health, University of Minnesota Medical School, Minneapolis, MN 55455, USA;
- School of Public Health, Universidad San Francisco de Quito, Quito 170901, Ecuador
| | - Elizabeth A. Albers
- Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN 55455, USA; (C.E.R.); (K.O.A.); (H.Y.); (E.A.A.); (T.P.S.); (J.E.G.)
| | - Tetyana P. Shippee
- Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN 55455, USA; (C.E.R.); (K.O.A.); (H.Y.); (E.A.A.); (T.P.S.); (J.E.G.)
| | - Arundhathi P. Sasikumar
- African Career Education and Resources Inc., Brooklyn Park, MN 55445, USA; (W.N.R.); (A.P.S.)
| | - Joseph E. Gaugler
- Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN 55455, USA; (C.E.R.); (K.O.A.); (H.Y.); (E.A.A.); (T.P.S.); (J.E.G.)
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Daniel NA, Hassan SA, Mohamed F, Sheikh N, Basualdo G, Schwartz R, Gebreselassie BT, Beyene YK, Gabreselassie L, Bayru K, Tadesse B, Libneh HA, Shidane M, Benalfew S, Ali A, Rao D, Kerani RP, Patel RC. Harambee! 2.0: The Impact of HIV-Related and Intersectional Stigmas on HIV Testing Behaviors Among African Immigrant Communities in Seattle, Washington. AIDS Behav 2022; 26:149-164. [PMID: 34368910 PMCID: PMC8349708 DOI: 10.1007/s10461-021-03396-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2021] [Indexed: 02/07/2023]
Abstract
African immigrants are disproportionately affected by HIV compared to U.S.-born individuals, and early HIV testing is the key challenge in ending the HIV epidemic in these communities. HIV-related stigma appears to be the most significant barrier to testing for HIV among African communities in King County, WA. In this formative study, we conducted thirty key informant interviews and five focus group discussions (n = total 72 participants) with Ethiopian, Somali, and Eritrean people living with HIV, health professionals, religious and other community leaders, and lay community members in King County to better understand HIV-related and intersectional stigmas' impact on HIV testing behaviors. We used inductive coding and thematic analysis. Participants from all communities reported similar themes for HIV-related and intersectional stigmas' influences on HIV testing behaviors. Misconceptions or poor messaging, e.g., regarding treatability of HIV, as well as normative or religious/moral beliefs around pre/extramarital sex contributed to HIV-related stigma. Intersecting identities such as immigrant status, race/ethnicity, and having a non-English language preference, all intermingle to further influence access to the U.S. healthcare system, including for HIV testing. These findings can be used to inform future research on community-led approaches to addressing early HIV testing amongst African immigrant communities.
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Affiliation(s)
| | - Shukri A Hassan
- Department of Medicine, UW, 325 9th Ave, Seattle, WA, 98105, USA
| | - Farah Mohamed
- Department of Medicine, UW, 325 9th Ave, Seattle, WA, 98105, USA
- Somali Health Board, Tukwila, WA, USA
| | - Najma Sheikh
- Department of Global Health, UW, Seattle, WA, USA
| | | | - Rahel Schwartz
- Ethiopian Community in Seattle, Seattle, WA, USA
- Ethiopian Health Board, Seattle, WA, USA
| | | | | | | | | | | | | | | | | | - Ahmed Ali
- Somali Health Board, Tukwila, WA, USA
- Department of Global Health, UW, Seattle, WA, USA
| | - Deepa Rao
- Department of Global Health, UW, Seattle, WA, USA
| | - Roxanne P Kerani
- Department of Medicine, UW, 325 9th Ave, Seattle, WA, 98105, USA
| | - Rena C Patel
- Department of Medicine, UW, 325 9th Ave, Seattle, WA, 98105, USA.
- Department of Global Health, UW, Seattle, WA, USA.
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Polonijo AN, Dubé K, Galea JT, Greene KY, Taylor J, Christensen C, Brown B. Attitudes Toward Payment for Research Participation: Results from a U.S. Survey of People Living with HIV. AIDS Behav 2022; 26:3267-3278. [PMID: 35386050 PMCID: PMC9474466 DOI: 10.1007/s10461-022-03660-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2022] [Indexed: 02/04/2023]
Abstract
Little is known about how payment affects individuals' decisions to participate in HIV research. Using data from a U.S. survey of people living with HIV (N = 292), we examined potential research participants' attitudes toward payment, perceived study risk based on payment amount, and preferred payment forms, and how these factors vary by sociodemographic characteristics. Most respondents agreed people should be paid for HIV research participation (96%) and said payment would shape their research participation decisions (80%). Men, less formally educated individuals, and members of some minoritized racial-ethnic groups were less likely to be willing to participate in research without payment. Higher payment was associated with higher perceived study risks, while preferences for form of payment varied by age, gender, education, race-ethnicity, and census region of residence. Findings suggest payment may influence prospective research participants' risk-benefit calculus and participation, and that a one-size-fits-all approach to payment could differentially influence participation among distinct sociodemographic groups.
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Affiliation(s)
- Andrea N. Polonijo
- grid.266096.d0000 0001 0049 1282Department of Sociology and the Health Sciences Research Institute, University of California, Merced, 5200 North Lake Road, Merced, CA 95343 USA
| | - Karine Dubé
- grid.10698.360000000122483208Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
| | - Jerome T. Galea
- grid.170693.a0000 0001 2353 285XSchool of Social Work, University of South Florida, Tampa, FL USA ,grid.170693.a0000 0001 2353 285XCollege of Public Health, University of South Florida, Tampa, FL USA ,grid.38142.3c000000041936754XDepartment of Global Health and Social Medicine, Harvard University, Boston, MA USA
| | - Karah Yeona Greene
- grid.170693.a0000 0001 2353 285XSchool of Social Work, University of South Florida, Tampa, FL USA
| | - Jeff Taylor
- HIV+Aging Research Project–Palm Springs, Palm Springs, CA USA
| | | | - Brandon Brown
- grid.266097.c0000 0001 2222 1582Department of Social Medicine, Population and Public Health, University of California, Riverside, Riverside, CA USA
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Cudjoe J, Nkimbeng M, Turkson-Ocran RA, Commodore-Mensah Y, Han HR. Understanding the Pap Testing Behaviors of African Immigrant Women in Developed Countries: A Systematic Review. J Immigr Minor Health 2021; 23:840-856. [PMID: 33165711 PMCID: PMC8747177 DOI: 10.1007/s10903-020-01119-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND African immigrant (AI) women remain burdened by cervical cancer, but the prevalence and correlates of Pap testing remains unclear in this population. OBJECTIVE To review studies on the prevalence and determinants of Pap testing among AI women living in developed countries. METHODS PubMed, CINAHL, Embase, and Scopus were searched for relevant articles that included African-born immigrant participants; were published in English; addressed the prevalence of Pap testing; conducted in a developed country; and identified correlates of Pap testing behavior. The Andersen Behavioral Model guided synthesis of the key findings. RESULTS Sixteen studies met the inclusion criteria. The prevalence of Pap testing ranged from 4.6% to 73.0%. Having a female provider and access to primary care facilitated Pap testing. Barriers to Pap testing included low income, male healthcare providers, and no history of gynecological exam. CONCLUSIONS Healthcare providers and social determinants-particularly income and healthcare access, play an important role in improving Pap testing among AI women. Larger qualitative and mixed methods studies are needed to explore other important determinants of Pap testing such as disease knowledge, self-efficacy, health literacy to reduce the burden of cervical cancer among AI women.
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Affiliation(s)
- Joycelyn Cudjoe
- School of Nursing, The Johns Hopkins University, 525 N. Wolfe Street, Baltimore, MD, 21205, USA.
- Inova Health System, 8110 Gatehouse Road, Falls Church, VA, 22042, USA.
| | - Manka Nkimbeng
- School of Nursing, The Johns Hopkins University, 525 N. Wolfe Street, Baltimore, MD, 21205, USA
- University of Minnesota School of Public Health, 420 Delaware St SE, Minneapolis, MN, 55444, USA
| | - Ruth-Alma Turkson-Ocran
- School of Nursing, The Johns Hopkins University, 525 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Yvonne Commodore-Mensah
- School of Nursing, The Johns Hopkins University, 525 N. Wolfe Street, Baltimore, MD, 21205, USA
- Center for Cardiovascular and Chronic Care, The Johns Hopkins School of Nursing, 525 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Hae-Ra Han
- School of Nursing, The Johns Hopkins University, 525 N. Wolfe Street, Baltimore, MD, 21205, USA
- Center for Cardiovascular and Chronic Care, The Johns Hopkins School of Nursing, 525 N. Wolfe Street, Baltimore, MD, 21205, USA
- Center for Community Innovation and Scholarship, The Johns Hopkins School of Nursing, 855 N Wolfe Street, Baltimore, MD, 21205, USA
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9
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Nwoke CN, Awosoga O, Leung BM. Recruitment Strategies Used in a Survey of African Immigrant Maternal Mental Health in Alberta, Canada. J Racial Ethn Health Disparities 2021; 9:1415-1421. [PMID: 34100262 PMCID: PMC8184054 DOI: 10.1007/s40615-021-01078-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 05/24/2021] [Accepted: 05/26/2021] [Indexed: 11/03/2022]
Abstract
African immigrant women are underrepresented in health research on maternal mental health. Thus, there is a need to highlight successful recruitment strategies to engage African women in health-oriented research. This paper offers insights on recruitment strategies utilized in recruiting African immigrant women in Alberta (Canada) with infants 2 years of age or under for a survey study on maternal mental health. We recruited 136 African immigrant women. Most participants were recruited by using already established social networks in the community. Other successful strategies included referral from community partners (i.e., immigrant organizations, cultural association, religious institutions), participants, utilizing an online survey tool (i.e., Qualtrics), and through family and friend networks (i.e., word-of-mouth). This study evidently highlights the importance of utilizing multiple recruitment strategies to successfully meet the desired sample size for a survey study. We believe the lessons learned during the process of recruitment will be helpful for others working with other African immigrant women populations in Canada and in other Western societies.
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Affiliation(s)
- Chinenye Nmanma Nwoke
- Faculty of Health Sciences, University of Lethbridge, 4401 University Drive, Lethbridge, AB, T1K 3M4, Canada.
| | - Oluwagbohunmi Awosoga
- Faculty of Health Sciences, University of Lethbridge, 4401 University Drive, Lethbridge, AB, T1K 3M4, Canada
| | - Brenda My Leung
- Faculty of Health Sciences, University of Lethbridge, 4401 University Drive, Lethbridge, AB, T1K 3M4, Canada
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10
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Cudjoe J, Budhathoki C, Roter D, Gallo JJ, Sharps P, Han HR. Exploring Health Literacy and the Correlates of Pap Testing Among African Immigrant Women: Findings from the AfroPap Study. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2021; 36:441-451. [PMID: 32410109 PMCID: PMC7666038 DOI: 10.1007/s13187-020-01755-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
African immigrant (AI) women have low rates of Pap testing. Health literacy plays a pivotal role in health behaviors. Sources and types of health information could shape health literacy and inform the Pap testing behaviors of AI women. However, the influences of health literacy, sources, and types of health information along with cultural and psychosocial correlates on the Pap testing behaviors of AI women are poorly understood. To examine how sources and types of health information impact health literacy, and in turn, how health literacy and cultural and psychosocial factors influence the Pap testing behaviors of AI women. An adapted Health Literacy Skills Framework guided the selection of variables for this cross-sectional study. Convenience sampling was used to recruit 167 AI women, 21-65 years. Multivariate logistic regression was used to assess correlates of Pap testing after adjusting for covariates (age, education, English proficiency, employment, income, health insurance, access to primary care, marital status, and healthcare provider recommendation). Most participants (71%) had received a Pap test in the past and used multiple (two or more) sources (65%) and types (57%) of health information. Using multiple sources of health information (aOR 0.11, p < 0.01) but not types of health information was associated with Pap testing. Having negative cultural beliefs (aOR 0.17, p = 0.01) and having high self-efficacy (aOR 9.38, p < 0.01) were significantly associated with Pap testing after adjusting for covariates. High health literacy (OR 3.23, p < 0.05) and high decisional balance (OR 5.28, p < 0.001) were associated with Pap testing in bivariate models but did not remain significant after controlling for covariates. Cultural beliefs was a significant correlate of AI women's Pap testing behaviors regardless of other known social determinants of health (education, English proficiency, age, access to primary care). Disseminating health information through various sources has the potential to promote Pap testing among AI women. Larger studies which utilize a robust sampling strategy and include a diverse group of AI women are needed in order to optimize health interventions aimed at improving Pap test screening behaviors among AI women.
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Affiliation(s)
- Joycelyn Cudjoe
- Johns Hopkins School of Nursing, 525 North Wolfe Street, Baltimore, MD, 21205, USA.
- Inova Health System, 8110 Gatehouse Road Suite 200W, Falls Church, VA, 22042, USA.
| | - Chakra Budhathoki
- Johns Hopkins School of Nursing, 525 North Wolfe Street, Baltimore, MD, 21205, USA
| | - Debra Roter
- Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, MD, 21205, USA
| | - Joseph J Gallo
- Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, MD, 21205, USA
| | - Phyllis Sharps
- Johns Hopkins School of Nursing, 525 North Wolfe Street, Baltimore, MD, 21205, USA
| | - Hae-Ra Han
- Johns Hopkins School of Nursing, 525 North Wolfe Street, Baltimore, MD, 21205, USA
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11
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Hussen SA, Kuppalli K, Castillo-Mancilla J, Bedimo R, Fadul N, Ofotokun I. Cultural Competence and Humility in Infectious Diseases Clinical Practice and Research. J Infect Dis 2020; 222:S535-S542. [PMID: 32926742 PMCID: PMC7489471 DOI: 10.1093/infdis/jiaa227] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Infectious diseases as a specialty is tilted toward social justice, and practitioners are frequently on the front lines of the battle against health inequity in practices that are diverse and sometimes cross international borders. Whether caring for patients living with the human immunodeficiency virus, tuberculosis, or Ebola, infectious diseases practitioners often interact with those at the margins of societies (eg, racial/ethnic/sexual/gender minorities), who disproportionately bear the brunt of these conditions. Therefore, cultural barriers between providers and patients are often salient in the infectious diseases context. In this article, we discuss cultural competence broadly, to include not only the knowledge and the skills needed at both the organizational and the individual levels to provide culturally appropriate care, but also to include "cultural humility"-a lifelong process of learning, self-reflection, and self-critique. To enhance the quality and the impact of our practices, we must prioritize cultural competence and humility and be mindful of the role of culture in the patient-provider-system interactions, in our larger healthcare systems, and in our research agendas and workforce development.
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Affiliation(s)
- Sophia A Hussen
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
- Grady Healthcare System, Atlanta, Georgia, USA
| | - Krutika Kuppalli
- Division of Infectious Diseases and Geographic Medicine, Center for Innovation in Global Health, Stanford University School of Medicine, Stanford, California, USA
| | - José Castillo-Mancilla
- Division of Infectious Diseases, Department of Internal Medicine, University of Colorado School of Medicine, Denver, Colorado, USA
| | - Roger Bedimo
- Division of Infectious Diseases, Department of Internal Medicine, University of Texas Southwestern Medical Center and Veterans Affairs North Texas Health Care System, Dallas, Texas, USA
| | - Nada Fadul
- Division of Infectious Diseases, Department of Internal Medicine, University of Nebraska School of Medicine, Omaha, Nebraska, USA
| | - Ighovwerha Ofotokun
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
- Grady Healthcare System, Atlanta, Georgia, USA
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Cudjoe J, Turkson-Ocran RA, Ezeigwe AK, Commodore-Mensah Y, Nkimbeng M, Han HR. Recruiting African Immigrant Women for Community-Based Cancer Prevention Studies: Lessons Learned from the AfroPap Study. J Community Health 2019; 44:1019-1026. [PMID: 31102117 PMCID: PMC6708449 DOI: 10.1007/s10900-019-00677-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Recruitment in research can be challenging, particularly for racial/ethnic minorities and immigrants. There remains a dearth of research identifying the health and sociocultural needs of these populations related to recruitment. To describe our experiences and lessons learned in recruiting African immigrant (AI) women for the AfroPap study, a community-based study examining correlates of cervical cancer screening behaviors. We developed several recruitment strategies in collaboration with key informants and considered published recruitment methods proven effective in immigrant populations. We also evaluated the various recruitment strategies using recruitment records and study team meeting logs. We enrolled 167 AI women in the AfroPap study. We used the following recruitment strategies: (1) mobilizing African churches; (2) utilizing word of mouth through family and friends; (3) maximizing research team's cultural competence and gender concordance; (4) promoting altruism through health education; (5) ensuring confidentiality through the consenting and data collection processes; and (6) providing options for data collection. Online recruitment via WhatsApp was an effective recruitment strategy because it built on existing information sharing norms within the community. Fear of confidentiality breaches and time constraints were the most common barriers to recruitment. We were successful in recruiting a "hard-to-reach" immigrant population in a study to understand the correlates of cervical cancer screening behaviors among AI women by using a variety of recruitment strategies. For future research involving African immigrants, using the internet and social media to recruit participants is a promising strategy to consider.
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Affiliation(s)
- Joycelyn Cudjoe
- School of Nursing, The Johns Hopkins University, 525 N. Wolfe Street, Baltimore, MD, 21205, USA.
| | - Ruth-Alma Turkson-Ocran
- School of Nursing, The Johns Hopkins University, 525 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Angelica K Ezeigwe
- School of Medicine, The Johns Hopkins University, 733 N. Broadway, Baltimore, MD, 21205, USA
| | - Yvonne Commodore-Mensah
- School of Nursing, The Johns Hopkins University, 525 N. Wolfe Street, Baltimore, MD, 21205, USA
- Center for Cardiovascular and Chronic Care, The Johns Hopkins School of Nursing, 525 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Manka Nkimbeng
- School of Nursing, The Johns Hopkins University, 525 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Hae-Ra Han
- School of Nursing, The Johns Hopkins University, 525 N. Wolfe Street, Baltimore, MD, 21205, USA
- Center for Cardiovascular and Chronic Care, The Johns Hopkins School of Nursing, 525 N. Wolfe Street, Baltimore, MD, 21205, USA
- Center for Community Innovation and Scholarship, The Johns Hopkins School of Nursing, 855 N Wolfe Street, Baltimore, MD, 21205, USA
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