Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Feb;7(1):6-11.
doi: 10.1111/cts.12127. Epub 2013 Nov 8.

Identifying barriers to healthcare to reduce health disparity in Zuni Indians using focus group conducted by community health workers

Vallabh O Shah  1 , Donica M Ghahate, Jeanette Bobelu, Phillip Sandy, Sara Newman, Deborah L Helitzer, Thomas Faber, Philip Zager
Affiliations

Identifying barriers to healthcare to reduce health disparity in Zuni Indians using focus group conducted by community health workers

Vallabh O Shah et al. Clin Transl Sci. 2014 Feb.

Abstract

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.

Keywords: American Indians; access to healthcare; barriers to healthcare; community health representatives (CHRs); community-based participatory research (CBPR); health disparity.

PubMed Disclaimer

References

    1. Minority Health and Health Disparities Research and Education Act United States Public Law 106–525 2000; 2498 Available at http://www7.nationalacademies.org/ocga/laws/PL106_525.asp Accessed October 21, 2013.
    1. Jha AK, Varosy PD, Kanaya AM, Hunninghake DB, Hlatky MA, Waters DD, Furberg CD, Shlipak MG. Differences in medical care and disease outcomes among black and white women with heart disease. Circulation 2003; 108: 1089–1094. - PubMed
    1. Philbin EF, McCullough PA, DiSalvo TG, Dec GW, Jenkins PL, Weaver WD. Underuse of invasive procedures among medicaid patients with acute myocardial infarction. Am J Public Health 2001; 91: 1082–1088. - PMC - PubMed
    1. Powe NR. To have and have not: health and health care disparities in chronic kidney disease. Kidney Int. 2003; 64: 763–772. - PubMed
    1. Brave Heart MY. The historical trauma response among natives and its relationship with substance abuse: a Lakota illustration. J Psychoactive Drugs 2003; 35: 7–13. - PubMed

Publication types