Identifying Barriers to Healthcare to Reduce Health Disparity in Zuni Indians Using Focus Group Conducted by Community Health Workers
Version of Record online: 8 NOV 2013
© 2013 Wiley Periodicals, Inc.
Clinical and Translational Science
Volume 7, Issue 1, pages 6–11, February 2014
How to Cite
Shah, V. O., Ghahate, D. M., Bobelu, J., Sandy, P., Newman, S., Helitzer, D. L., Faber, T. and Zager, P. (2014), Identifying Barriers to Healthcare to Reduce Health Disparity in Zuni Indians Using Focus Group Conducted by Community Health Workers. Clinical and Translational Science, 7: 6–11. doi: 10.1111/cts.12127
- Issue online: 14 FEB 2014
- Version of Record online: 8 NOV 2013
- National Center for research Resources. Grant Number: 5P20RR016480–12
- National Institute of General Medical Sciences. Grant Number: 8P20GM103451–12
- National Center for Advancing Translational Sciences of the National Institutes of Health. Grant Number: 8UL1TR000041
- The University of New Mexico Clinical and Translational Science Center
- American Indians;
- health disparity;
- barriers to healthcare;
- access to healthcare;
- community health representatives (CHRs);
- community-based participatory research (CBPR)
The Zuni Pueblo is home to an economically disadvantaged population, which faces a public health challenge from the interrelated epidemics of obesity, diabetes and kidney disease. Efforts to decrease the impact of these epidemics have been complicated by historical, economic and cultural barriers, which may limit healthcare utilization. The NIH supported Zuni Health Initiative (ZHI) conducted a study to identify barriers to healthcare in the Zuni Pueblo.
Community health representatives (CHRs) led 14 one-hour focus group sessions at which a total of 112 people participated posed unique questions that took into account the Zuni culture to elicit information on perceived barriers to healthcare. Audiotapes were translated and transcribed by bilingual ZHI staff. We reduced the text to thematic categories, constructed a coding dictionary and inserted the text into NVivo 9 program.
We identified nine themes emerged regarding the barriers experienced in receiving healthcare and adhering to medical advice. These included distance; transportation; embarrassment; relating to healthcare professionals; navigating the medical system; awareness of available resources; waiting times; adhering to medication; and incentives in health promotion.
In conclusion the implementation of culturally appropriate community-based health promotion programs and preventive screening techniques will improve access to healthcare and diminish health disparities.