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Perceptions of Stroke Risks among West African Male Immigrants in San Diego: A Qualitative Investigation

Lawrence A Agi, Vasileios Margaritis, Jeanne Connors

There are few studies that focus on the health beliefs, knowledge and perceptions of stroke in West African populations, especially English-speaking male immigrants residing in San Diego, California. Health promotion targeting to control stroke must take into consideration the community’s awareness of the warning signs and risk factors of this disease. The aim of this study was to evaluate the role of culture in defining the perception and understanding of the warning signs and risk factors of stroke among male English speaking foreign-born West African immigrants in San Diego. This qualitative study employed an ethnographic methodology involving 8 male participants, 4 each from the Nigerian and Ghanaian communities in San Diego, and applied the principle of saturation. An unstructured in-depth interview was used to collect data from the participants who were recruited through snowball and network sampling framework. A thematic approach was used in the data analysis. The data obtained from each participant were initially coded using line-by-line open coding to develop a list of codes that were relevant to the research topic. Similar codes were combined and developed manually into themes. The individual transcripts were then downloaded onto the NVivo10 software and were reviewed for common words and phrases through the queries (i.e., frequent words and word clouds). Eight central themes about cultural knowledge of health beliefs and practices in terms of the health of immigrant men were extracted and clustered from the qualitative analysis: (1) cultural beliefs of the cause of stroke, (2) prevention of stroke, (3) self-identity barrier, (4) awareness/knowledge of stroke, (5) awareness of the warning signs of stroke, (6) knowledge of the risk factors of stroke, (7) individuals access preventive health care services to prevent stroke, and (8) men seek the opinion of their wives on health issues.