217351 Applying Structural Equation Model to Understanding Immunization Inequities among the Hmong Community

Sunday, November 7, 2010

Dian Baker, PhD, APRN-BC, PNP, PHN , Betty Irene Moore School of Nursing, University of California Davis, Sacramento, CA
Michelle Dang, MSN, RN , Division of Nursing, California State University Sacramento, Sacramento, CA
May Ying Ly, MSW , Healthy Start, Sacramento City Unified School District, Sacramento, CA
Rafael Diaz, PhD , Department of Mathematics and Statistics, California State University Sacramento, Sacramento, CA
Aims: Describe factors related to perception of barriers of immunization in the Hmong community Methods: Community-based participatory research using a standardized, community-based instrument was used to explore barriers to immunization in the Hmong community. A total of 417 Hmong parents and caregivers completed the survey. A structural equation model (SEM) was created to determine factors that contribute to perceived barriers. Results: The SEM included three factors– nativity, socioeconomic position, and use of traditional healthcare (inclusion of shamans and herbalists in healthcare) – as potential predictors of barriers to immunization. Lower socioeconomic position and use of traditional healthcare significantly predicted higher perceived barriers to immunization. However, nativity, as indicated by years in the U.S, age of arrival to the U.S., and English language fluency, did not predict perceived barriers. Conclusions: Despite significant public health efforts to provide universal immunization coverage, inequities persist for children of Hmong origin. Interventions aimed at reducing immunization inequities need to consider distinct sociocultural factors that impact immunization rates among different refugee and immigrant groups. SEM is a useful research tool for understanding the complexities of health inequities in refugee and immigrant groups.

Learning Areas:
Assessment of individual and community needs for health education
Diversity and culture
Protection of the public in relation to communicable diseases including prevention or control
Public health or related research
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
1. Explain how factors related to social determinants of health and health inequities in the Hmong community are mutually constitutive 2. Describe how structural equation modeling can be applied to health inequities research

Keywords: Asian Americans, Social Inequalities

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have over 15 years of experience working with the Hmong community on issues related to health and health inequities. I have conducted several community based participatory research projects with the Hmong community.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.