Language and cultural difference a barrier to flu shot compliance in minority populations

Ensuring compliance with flu vaccination involves using the right words and the right message, according to a new report.

Minority patients who refuse vaccines aren’t always hearing the right message, according to a new report.

A new case study from HMS reveals that minority groups who have the lowest rates of flu vaccination have a number of barriers, with language and cultural misconceptions playing a large role.

Through their member outreach and engagement work with health plans, HMS contacted more than 5 million consumers to encourage flu vaccination over the course of three years. Through these engagements, HMS was able to survey the same consumer population to find out why misconceptions such as, “the flu vaccine will give me the flu,” exist in the Spanish-speaking community.

The data reveals that consumers who have the lowest rates of flu vaccination have a number of barriers, with language and cultural misconceptions playing a large role.

“Oftentimes in the healthcare industry, the word used for flu in the U.S. is the word for the common cold in Spanish,” said Mara Jimenez, Manager of Health Engagement Design and Hispanic Communications for HMS, explaining that “gripe” in Spanish means cold, whereas many Hispanics know flu simply as “influenza” in their native tongue.

“If you do a word-for-word translation of the script, gripe is used instead of influenza,” said Ellen Harrison, RN, Vice President of Operations and Market Strategy for HMS. “What we found is that we needed to culturally adapt those scripts we’re using in an outreach program to make sure it’s not a word-for-word translation, and to be careful about how they are interpreted. We can’t do a verbatim translation, rather we need a culturally adapted translation.”

Jimenez said the survey assessed other barriers for patients who refused vaccines, particularly in Spanish-speaking patients have higher rates of refusal. Language barriers are one piece, but some people also have a more negative perception about vaccines and healthcare in general than others.

“It is important you take into account the cultural aspect, like the family connection-getting vaccinated to protect infants and elderly family members-and connecting them to a Spanish-speaking pharmacy to get a flu shot,” Jimenez said.

The data revealed that 52 percent of Spanish-speaking patients polled didn’t plan to get the flu shot because they doubted its efficacy compared to just 30 percent of English-speaking patients, and 50 percent of Spanish-speaking participants were afraid the flu shot would give them the flu compared to 39 percent of English-speaking participants. Another 62 percent of Spanish-speaking participants were worried about the safety of the flu vaccine compared to 50 percent of English-speaking participants, and 24 percent of Spanish-speaking participants said the cost of the flu vaccine was prohibitive compared to 15 percent of English-speaking participants.

Harrison said it’s important not only to make sure that providers use a language patients understand, but also to deliver a message that resonates with them, as well. She said educational marketing materials that are both the correct language and culturally-adapted will have the greatest impact.

“We can’t assume everyone reads the same message the same way. We want to make sure these messages aren’t just a blast of information, but that they will resonate with consumers,” Harrison said. “Overall, we need different messaging and more frequent touch points.”

Spanish-speaking staff would provide additional benefit, she added, but even more important is creating a relationship with high-risk patients who have poor compliance.

“The healthcare system is different here than in other countries,” Jimenez said. “We should strive to create an environment that helps non-native speakers navigate the system.”