Abstract

African immigrants make up a large subgroup of Black/African-Americans in the US. However, because African immigrant groups are typically categorized as “Black,” little is known about their preventative healthcare needs. Differences in culture, life and healthcare experiences between African immigrant populations and US-born people may influence preventive health care uptake. Thus, policymakers and healthcare providers lack information needed to make informed decisions around preventive care for African immigrants. This formative study was conducted among the largest East African immigrant communities in King County, WA. We recruited religious leaders, community leaders, health professionals, and lay community members to participate in thirty key informant interviews and five focus group discussions (n = 72 total), to better understand preventative healthcare attitudes in these communities. Through inductive coding and thematic analysis, we identified factors that impact preventative healthcare attitudes of the Somali, Ethiopian and Eritrean immigrant communities and deter them from accessing and utilizing healthcare. Cultural beliefs and attitudes around preventative healthcare, mistrust of westernized healthcare, religious beliefs/views, intersecting identities and shared immigrant experiences all influence how participants view preventative healthcare. Our results suggest that interventions that address these factors are needed to most effectively increase uptake of preventative healthcare in African immigrant communities.

Highlights

  • MethodsThis study was part of an academia-community partnership between the University of Washington (UW) researchers and the Somali, Ethiopian and Eritrean health organizations in King County, WA [31,32]

  • African immigrants represent a small but growing share of the American population, increasing 251% from 2000 to 2016

  • Five individuals identified as people living with HIV (PLWHIV), and all were key informant interviews (KIIs) participants

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Summary

Methods

This study was part of an academia-community partnership between the University of Washington (UW) researchers and the Somali, Ethiopian and Eritrean health organizations in King County, WA [31,32]. This partnership arose from our ongoing work to address barriers to HIV testing amongst local African immigrant communities utilizing the principles of community-based participatory research. The project team consisted of three primary investigators, two of which belonged to. All investigators considered how their positionalities differed from participant experiences, and took a learning perspective to interactions with participants in order to minimize bias. All members of the project team met regularly during project planning stages, implementation, analysis, and community dissemination

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