Needles, Jabs and Jags: a qualitative exploration of barriers and facilitators to child and adult immunisation uptake among Gypsies, Travellers and Roma

BMC Public Health

Research Article

Louise Condon¹  Helen J. Lewis²  Cath Jackson²  Karen Overend²  Lisa Dyson²  Zoe Richardson²  Sarah Redsell³  Carol Emslie⁴  Susan Kerr⁴  Lana Ireland⁴  Francine M. Cheater⁵  Philippa Kemsley⁶  Helen Bedford⁶  Julie Mytton⁷  Christine Shepherd⁸  Lesley Smith⁸ 

[1] College of Human and Health Sciences, Swansea University, Singleton Park, SA2 8PP, Swansea, Wales, UK;Department of Health Sciences, University of York, Heslington, YO10 5DD, York, UK;Faculty of Health, Social Care and Education, Anglia Ruskin University, Young Street Site, East Road Campus, CB1 1PT, Cambridge, UK;Institute for Applied Health Research, School of Health & Life Sciences, Glasgow Caledonian University, Cowcaddens Road, G4 0BA, Glasgow, UK;School of Health Sciences, University of East Anglia, Norwich Research Park, NR4 7TJ, Norwich, UK;UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, WC1N 1EH, London, UK;University of the West of England, Centre for Child and Adolescent Health, Oakfield House, Oakfield Grove, BS8 2BN, Bristol, UK;York Travellers Trust, 20 Falsgrave Crescent, YO30 7AZ, York, UK;

关键词: Immunisation;    Immunization;    Vaccination;    Travellers;    Gypsies;    Roma;    Showpeople;    Lay beliefs;    Barriers;    Facilitators;   

DOI  :  10.1186/s12889-017-4178-y

 received in 2016-09-02, accepted in 2017-03-07,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundGypsies, Travellers and Roma (referred to as Travellers) are less likely to access health services including immunisation. To improve immunisation rates, it is necessary to understand what helps and hinders individuals in these communities in taking up immunisations. This study had two aims.Investigate the views of Travellers in the UK on the barriers and facilitators to acceptability and uptake of immunisations and explore their ideas for improving immunisation uptake;Examine whether and how these responses vary across and within communities, and for different vaccines (childhood and adult).MethodsThis was a qualitative, cross-sectional interview study informed by the Social Ecological Model. Semi-structured interviews were conducted with 174 Travellers from six communities: Romanian Roma, English Gypsy/Irish Travellers (Bristol), English Gypsy (York), Romanian/Slovakian Roma, Scottish Show people (Glasgow) and Irish Traveller (London). The focus was childhood and selected adult vaccines. Data were analysed using the Framework approach.ResultsCommon accounts of barriers and facilitators were identified across all six Traveller communities, similar to those documented for the general population. All Roma communities experienced additional barriers of language and being in a new country. Men and women described similar barriers and facilitators although women spoke more of discrimination and low literacy. There was broad acceptance of childhood and adult immunisation across and within communities, with current parents perceived as more positive than their elders. A minority of English-speaking Travellers worried about multiple/combined childhood vaccines, adult flu and whooping cough and described barriers to booking and attending immunisation. Cultural concerns about antenatal vaccines and HPV vaccination were most evident in the Bristol English Gypsy/Irish Traveller community. Language, literacy, discrimination, poor school attendance, poverty and housing were identified as barriers across different communities. Trustful relationships with health professionals were important and continuity of care valued.ConclusionsThe experience of many Travellers in this study, and the context through which they make health decisions, is changing. This large study identified key issues that should be considered when taking action to improve uptake of immunisations in Traveller families and reduce the persistent inequalities in coverage.Trial registrationCurrent Controlled Trials ISRCTN20019630.

【 授权许可】

CC BY   
© The Author(s). 2017