Adapting the Andersen Model to a Francophone West African Immigrant Population: Hepatitis B Screening and Linkage to Care in New York City

• DOI: 10.1007/s10900-014-9916-9
• Publication Date: 2014-07-07T10:03:02Z
• Authors: Demetri A. Blanas; Kim Nichols; Mulusew Bekele; Hari Shankar; Saba Bekele; Lina Jandorf; Saria Izzeldin; Daouda Ndiaye; Adama Traore; Motahar Bassam; Ponni V. Perumals...
• Keywords: Adult; Male; Health Services Needs and Demand; Internet; 1. No poverty; Black People; Emigrants and Immigrants; Social Support; Focus Groups; Middle Aged; Translating; Hepatitis B; Health Services Accessibility; 3. Good health; Africa, Western; 03 medical and health sciences; Socioeconomic Factors; Humans; Mass Screening; Female; New York City; Perception; 0305 other medical science; Language

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.