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J Community Health. 2015 Feb;40(1):175-84. doi: 10.1007/s10900-014-9916-9.

Adapting the Andersen model to a francophone West African immigrant population: hepatitis B screening and linkage to care in New York City.

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Institute for Family Health, Harlem Residency in Family Medicine, 1824 Madison Ave, New York, NY, 10035, USA,


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.

[Indexed for MEDLINE]

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