Clustering of chronic hepatitis B screening intentions in social networks of Moroccan immigrants in the Netherlands.
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ABSTRACT:
SUBMITTER: Hamdiui N
PROVIDER: S-EPMC7077096 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:This study examines the relationship between residential segregation and social trust of immigrants and natives in the Netherlands. Building on previous studies that have found evidence for a negative segregation-trust link, we present a nuanced narrative by (i) distinguishing between an ethnic minority and majority perspective, (ii) elaborating theoretical foundations on the moderating role of individual exposure in the form of ethnic minority concentration in the neighborhood, and (iii) taking income segregation into account. In addition to the refined theoretical framework, our study employs a rigorous empirical approach. Using two waves (2009 and 2013) of the Netherlands Longitudinal Lifecourse Study-a geocoded panel study with an oversampling of Moroccan and Turkish immigrants-we are able to study the influence of (changes in) municipality-level segregation patterns for both natives and immigrants, and consider the roles of both neighborhood ethnic minority concentration, as well as income-based segregation. Results from four-level multilevel models show that ethnic segregation is negatively related to the social trust of immigrants. At the same time, this negative relationship is particularly strong in neighborhoods with a low level of minority population concentration, which provides support for the so-called integration paradox where negative intergroup interactions reduce social trust. For respondents of Dutch origin, we find no evidence that their social trust is sensitive to ethnic segregation or that this relationship is conditional on minority concentration at the neighborhood level.
| S-EPMC8022758 | biostudies-literature
Project description:In November 2016, the Dutch Health Council recommended hepatitis B (HBV) screening for first-generation immigrants from HBV endemic countries. However, these communities show relatively low attendance rates for screening programmes, and our knowledge on their participation behaviour is limited. We identified determinants associated with the intention to request an HBV screening test in first-generation Moroccan-Dutch immigrants. We also investigated the influence of non-refundable costs for HBV screening on their intention.Offline and online questionnaires were distributed among first- and second/third-generation Moroccan-Dutch immigrants using respondent-driven sampling. Random forest analyses were conducted to determine which determinants had the greatest impact on (1) the intention to request an HBV screening test on one's own initiative, and (2) the intention to participate in non-refundable HBV screening at €70,-.Of the 379 Moroccan-Dutch respondents, 49.3% intended to request a test on their own initiative, and 44.1% were willing to attend non-refundable screening for €70,-. Clarity regarding infection status, not having symptoms, fatalism, perceived self-efficacy, and perceived risk of having HBV were the strongest predictors to request a test. Shame and stigma, fatalism, perceived burden of screening participation, and social influence of Islamic religious leaders had the greatest predictive value for not intending to participate in screening at €70,- non-refundable costs. Perceived severity and possible health benefit were facilitators for this intention measure. These predictions were satisfyingly accurate, as the random forest method retrieved area under the curve scores of 0.72 for intention to request a test and 0.67 for intention to participate in screening at €70,- non-refundable costs.By the use of respondent-driven sampling, we succeeded in studying screening behaviour among a hard-to-reach minority population. Despite the limitations associated with correlated data and the sampling method, we recommend to (1) incorporate clarity regarding HBV status, (2) stress the risk of an asymptomatic infection, (3) emphasise mother-to-child transmission as the main transmission route, and (4) team up with Islamic religious leaders to help decrease elements of fatalism, shame, and stigma to enhance screening uptake of Moroccan immigrants in the Netherlands.
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Project description:Background:Chronic hepatitis B (HBV) leads to an increased risk for liver cirrhosis and liver cancer. In the Netherlands, chronic HBV prevalence in the general population is 0.20%, but 3.77% in first generation immigrants. Our aim was to identify determinants associated with the intention to participate in HBV testing among first generation Moroccan immigrants, one of the two largest immigrant groups targeted for screening. Methods:Semi-structured interviews were held with first (n = 9) and second generation (n = 10) Moroccan-Dutch immigrants, since second generation immigrants frequently act as their parents' brokers in healthcare. Results:Most participants had little knowledge about hepatitis B, but had a positive attitude towards screening. Facilitators for screening intention were perceived susceptibility to and severity of disease, positive attitude regarding prevention, wishing to know their hepatitis B status and to prevent potential hepatitis B transmission to others. Additional cultural facilitators included fear (of developing cancer), and existing high health care utilization; a religious facilitator was the responsibility for one's own health and that of others. Barriers included lack of awareness and knowledge, practical issues, not having symptoms, negative attitude regarding prevention, fear about the test result and low-risk perception. A cultural barrier was shame and stigma, and a religious barrier was fatalism. Conclusion:We identified important facilitators and barriers, which we found, can be interpreted differently. Specific and accurate information should be provided, accompanied by strategies to address shame and stigma, in which Islamic religious leaders could play a role in bringing information across.
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Project description:Hepatitis B (HBV) is endemic in Haiti, therefore Haitian immigrants should be screened to identify and link affected individuals to care. Current screening approaches are ineffective. We assessed the acceptability and feasibility of home-based screening among Haitian immigrants using community health workers (CHWs). We recruited participants exiting a pragmatic trial evaluating strategies to improve care delivery (NCT02970136). Participants completed an acceptability questionnaire. Blood drawn by CHWs at participants' homes or community sites was tested for hepatitis B surface antigen, hepatitis B surface antibody and hepatitis B core antibody. Of 60 participants, 59 found screening acceptable; 53 had blood drawn. Of those, 45.3% had HBV previously, 49.1% remained susceptible and 5.7% were vaccinated. Respondents cited various reasons community members might find screening unacceptable. The high prior HBV rate highlights the need for effective outreach programs. Home-based HBV screening was both acceptable and feasible among Haitian immigrants.
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Project description:This paper discusses the limitations of harmonised sampling designs for survey research on immigrants in Germany and the Netherlands. Although the concepts for immigrants are largely similar in both countries, there are severe constraints when it comes to comparable sampling designs. While in the Netherlands a sample can be drawn from a national population register by Statistics Netherlands, this is impossible in Germany due to the decentralised setup of the population register and legal restrictions on merging existing databases. Harmonisation of immigrant statistics is thus less a problem at the concept level than in the implementation. Achieving a harmonised data collection on immigrants for Germany and the Netherlands will be a major challenge.
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