Understanding Cultural and Knowledge Barriers to Acute Stroke Care in the Los Angeles Filipino American Community
Antonio Moya, Linh Doan Vo, Vincent Grospe, Julia Brock, Eric Chen, MarySue Heilemann
UCLA National Clinician Scholars Program, University of California, Los Angeles
Introduction: Filipino Americans (FilAms) in Los Angeles make up the largest Filipino community outside of the Philippines and 2nd largest Asian subgroup in L.A. County. FilAms also have higher rates of stroke, high blood pressure, and diabetes not only compared to other Asian subgroups but also to African American and Latino communities. Little is known about FilAm knowledge and cultural barriers in accessing acute stroke care.
Methods: Using a qualitative descriptive design, we studied knowledge, attitudes, and health behaviors of the L.A. FilAm community with regard to acute stroke care by conducting 5 focus groups of 5-7 people each and 6 semi-structured interviews with key community leaders. Participants were recruited through L.A. FilAm community organizations. We conducted thematic analysis, coding for themes on barriers to acute stroke care.
Results: Two key themes have emerged: 1) spiritualistic fatalism and the belief that God is in control of all outcomes despite an individual’s will and 2) fear of calling 911, specifically linked to shame in being perceived as unhealthy by neighbors, fear of deportation among undocumented FilAms, and fear of high ambulance cost.
Conclusion: Beliefs related to spiritualistic fatalism and fear of calling 911 are powerful barriers to acute stroke care among FilAms. The results can inform a culturally-relevant intervention for the community using social media, the Internet, and Filipino television programs to encourage FilAms to obtain acute stroke care. Lessons from this project will be used to create stroke education for other U.S. Asian Pacific Islander communities.
Keywords: stroke care, public health interventions, grounded theory