Impact of COVID-19 on Marshallese communities in the United States / Pearl A. McElfish [and nineteen others].

Format:

Book

Author/Creator:

McElfish, Pearl A., author.

Series:

Final research report (Patient-Centered Outcomes Research Institute (U.S.))

Language:

English

Subjects (All):

Health services accessibility.

Physical Description:

1 online resource (89 pages) : illustrations.

Place of Publication:

Washington, DC : Patient-Centered Outcomes Research Institute, 2022.

Summary:

BACKGROUND: Marshallese Pacific Islander adults in the United States experience disparities in chronic diseases and health care access. COVID-19 has exacerbated these disparities. In Arkansas, disproportionate rates of COVID-19 infections, hospitalizations, and deaths have been observed among Marshallese compared with those of other racial and ethnic groups in the state. OBJECTIVES: To reduce the disparities caused by COVID-19, an enhancement study was awarded to understand Marshallese adults' lived experiences during the COVID-19 pandemic. The specific aims of the study were to document Marshallese community members' (1) level of adherence to preventative recommendations, (2) social and economic impacts because of COVID-19, (3) preferred COVID-19 testing locations, (4) diabetes self-care behaviors during COVID-19, (5) telemedicine use, and (6) COVID-19 vaccine willingness/hesitancy. METHODS: We recruited Marshallese adults to complete an online, self-administered national survey. Recruitment was conducted through social media and Marshallese-serving community-based organizations, as well as through outreach from community health workers and community partners. Inclusion criteria included (1) self-reported Marshallese identity, (2) being 18 years of age or older, and (3) living in the continental United States or Hawaii. Data collection for the online survey began in July 2020 and concluded in November 2020. Quantitative data analysis of the survey results included descriptive as well as inferential statistical techniques, including correlation, t tests, and nonparametric tests. We also recruited Marshallese adults to participate in qualitative interviews conducted as focus groups between September 2020 and November 2020. The focus groups were conducted in Marshallese or English, based on participant preference. The focus groups were recorded, transcribed verbatim, translated as necessary, and coded. Data were analyzed using a qualitative descriptive research design. RESULTS: A total of 120 Marshallese adults from 13 states responded to the online survey. The mean (SD) age was 35.5 (8.8) years, and 64.2% were female. More than a third (35.7%) were uninsured, and 43.6% had no primary care provider. Participants largely adhered to suggested preventative behaviors, including wearing face masks, disinfecting surfaces, and staying home when feeling sick. More than a quarter of participants (27.5%) reported a positive COVID-19 test result. More than half (56.6%) reported that they were very or somewhat likely to get the COVID-19 vaccine; however, a substantial proportion (28.3%) reported that they did not know or were not sure if they would accept the vaccine. Participants reported significant disruptions in employment, income, and housing and difficulty accessing health care because of the pandemic. Changes in health behaviors, such as eating habits and physical activity, were also documented. Fifty-three Marshallese adults from 3 states took part in 9 virtual focus groups. The key themes identified in the qualitative data included cultural disruptions related to COVID-19, experiences of diabetes self-care, and willingness and hesitancy regarding COVID-19 vaccination. CONCLUSIONS: The results of this enhancement study highlight the broad social and economic impacts of the COVID-19 pandemic on the Marshallese community, further compounding disparities in COVID-19 infections, hospitalizations, and deaths. The results of the study were immediately used by the researchers, local health care partners, Arkansas Department of Health, and Marshallese community-based organizations to inform a comprehensive COVID-19 response plan that included culturally and linguistically tailored COVID-19 prevention education, testing, contact tracing, and navigation for assisted quarantine. The information will also be used to inform interventions that promote COVID-19 vaccination distribution and uptake in this at-risk population. LIMITATIONS: The primary limitation to this study was the nonrandom sample. All participants in the survey were Marshallese adults living across the United States; however, the final sample was younger and more educated, had higher income earners, and had fewer chronic conditions compared with samples of Marshallese individuals that have been examined in the past.

Contents:

Background

Participation of Patients and other Stakeholders

Methods

Quantitative Results

Qualitative Results

Discussion

Conclusions

References

Related Publications

Acknowledgments

Appendices.

Notes:

Description based on publisher supplied metadata and other sources.