Social-cultural, Religious, and Health System Barriers to Hepatitis B Screening Among HMONG: A Case Study

Social-cultural, Religious, and Health System Barriers to Hepatitis B Screening Among HMONG: A Case Study

Author: 
Dao Moua Fang
Program of study: 
D.H.A.
Abstract: 
As immigrants from the Southeast Asia country of Laos, the Hmong people are disproportionally impacted by the hepatitis B infection and liver cancer compared to Non-Hispanic White. This study was framed using the Health Belief Model and the Culture Care Theory. The purpose of this study was to examine the Hmong’s perceptions on social-cultural determinants, traditional health beliefs, religious practices, and health care system barriers that influenced community-based hepatitis B screening interventions. This study involved a qualitative method, integrating a collective case study research design. In-depth interviews were used to collect data from 20 Hmong adults from Northern California who participated in the Chen et al. (2013) study. A purposive sampling approach was used to recruit participants who were not serologically tested for hepatitis B. A pattern matching analytic technique was used to analyze the data. There were five themes submerged under the social-cultural factors category: care supporters, clan leaders, cultural barriers, health decision maker, and family and friend advice. There were three themes submerged under the traditional belief category: cultural beliefs on illness, values, and lifeway; traditional beliefs on causes of hepatitis B; and traditional treatments. Barriers to health care services, doctor’s characteristics, and suggestions for the U.S. health care system to improve hepatitis B screening were the themes that emerged under the health care system factors. Low literacy and no formal education were themes emerged under educational factors. Father managing the family budget, Medicaid health insurance, receive care from primary care physician were themes emerged under economic factors.
Dedication: 
I dedicate this dissertation to my loving family especially my amazing and understanding husband, Lanxiene, who has supported me through many years of schooling and devotion into making this dream become a reality; to my children Alisha, Gobe, Arlene, and Ashlee for your love and support; to my mother, brothers and sisters who have encouraged and motivated me throughout the doctoral journey. I also dedicate this dissertation to my niece, Mao, who has reviewed all of my research papers. Above all to my father, Wang Doua Moua, who has inspired and motivated me to work hard, to be a better person, and be a role model for my siblings.
Acknowledgements: 
First and foremost, I would like to acknowledge my dissertation chair, Dr. Jigoulov, for his scholarly support and responsiveness. You have made the dissertation process an enjoyable journey. I would also like to acknowledge my committee members Dr. Stewart and Dr. Justus who continued to support and provide many insights throughout the entire dissertation process. In addition, I would like to acknowledge Dr. Moon Chen who has encouraged and inspired me to pursue my doctoral degree. Thank you for your guidance and for supporting me to get through the UCD IRB hurdle. I would also like to acknowledge Dr. Dian Baker for your mentorship and support. Furthermore, I would like to acknowledge the Hmong Cultural Center of Butte County for supporting me throughout the research process. This dissertation would have not been possible without your support. Also, I would like to thank the Hmong community for trusting me to share their health care experiences.