A Pilot Study: Understanding Health Literacy and Linguistic Factors Related to African Immigrants Engagement in Primary Health Care in Massachusetts

Culture impacts how individuals understand, communicate, and respond to health information. Immigrants to the U.S. come from diverse cultural groups and have varying understandings of health care and the U.S. health care system. The primary aim of this study is to explore cultural interpretations and beliefs of select health concepts and to assess the health literacy of African immigrants in Massachusetts. We are a partnership between UMass Graduate School of Nursing, Africans for Improved Access program at the Multicultural AIDS Coalition and Clark University. Using a CBPR approach has been valuable in the design of the study and in our ability to access and engage African immigrants. We are recruiting 100 African immigrants during cultural events, targeted outreach and gatherings in religious communities to complete a Freelist exercise, 2 health literacy assessment tools, and a general health survey. Results of the Freelist exercise will inform development of an interview guide that will be used with 3 Focus Groups of African immigrants to help us understand the cultural interpretation of frequently used health related words and phrases. We are assessing the feasibility and acceptability of 2 health literacy instruments to determine the appropriateness of using these assessments with an immigrant population. The association of health literacy to accessing primary care will be examined. The focus group and general health survey data will help us gain a better understanding of the primary care health experiences of African immigrants and potential factors that facilitate or hinder their engagement in primary health care.