title: Access and utilization of healthcare services in Massachusetts, United States: a qualitative study of the perspectives and experiences of Brazilian-born immigrant women.
abstract: Understanding immigrants' interactions with the United States (US) healthcare system will likely make it possible to meet their healthcare needs and improve their quality of life in the US. Although challenges to accessing and utilizing healthcare in the US have been identified, there is little information specific to Brazilian-born immigrants' experiences. Brazilians comprise a fast-growing immigrant population group in the US. The purpose of this study was to explore Brazilian immigrant women's perspectives and experiences with healthcare services in the US to gain insights into factors amenable to interventions that may contribute to disparities in access to and utilization of services.
  
  
  
  Five focus groups were conducted from April to May in 2015 using a purposeful sampling of Brazilian-born immigrant women living in Massachusetts, US.
  
  
  
  Thirty-five women participated in this study. Although participants expressed their overall satisfaction with the US healthcare system, they noted several barriers to care, including sociocultural differences in delivery of care and communication barriers, including inconsistent quality of interpreting services.
  
  
  
  This study provides new information on the experiences and challenges faced by Brazilian immigrant women in accessing and utilizing healthcare services in the US and points out opportunities for improving services and the overall health of this immigrant population. Addressing noted sociocultural differences and communication barriers including inconsistent quality of hospital's interpreting services might enhance Brazilian-born immigrants' experiences with the healthcare system.
authors: Exercise and Health Sciences Department, College of Nursing and Health Sciences, University of Massachusetts Boston, 100 Morrissey Boulevard, Boston, MA, 02125, USA. Ana.Lindsay@umb.edu.|Department of Nutrition, Harvard School of Public Health, Boston, MA, USA. Ana.Lindsay@umb.edu.
authors: Ana C
authors: AC
authors: Lindsay
authors: Federal University of Ceara, Nursing School, Fortaleza, Ceara, Brazil.
authors: Mariana Gonçalves
authors: MG
authors: de Oliveira
authors: Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC, USA.
authors: Sherrie F
authors: SF
authors: Wallington
authors: Department of Kinesiology, University of Rhode Island, Health Studies, Kingston, RI, USA.
authors: Mary L
authors: ML
authors: Greaney
authors: Department of Public Health, Federal University of Ceara, School of Medicine, Fortaleza, Ceara, Brazil.
authors: Marcia Maria Tavares
authors: MM
authors: Machado
authors: Federal University of Ceara, Nursing School, Fortaleza, Ceara, Brazil.
authors: Lorita M
authors: LM
authors: Freitag Pagliuca
authors: Department of Public Health, Federal University of Ceara, School of Medicine, Fortaleza, Ceara, Brazil.
authors: Carlos Andre Moura
authors: CA
authors: Arruda
mesh_terms: D000328:Adult; D001938:Brazil / Q000208:ethnology; D003144:Communication Barriers; D054242:Emigrants and Immigrants / Q000523:psychology*; D005260:Female; D017144:Focus Groups; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D054625:Healthcare Disparities; D006801:Humans; D008404:Massachusetts; D008427:Maternal Health Services / Q000706:statistics & numerical data; D008484:Medicaid / Q000592:standards; D008875:Middle Aged; D036801:Parturition; D010342:Patient Acceptance of Health Care / Q000208:ethnology; D011247:Pregnancy; D036301:Qualitative Research; D011788:Quality of Life; D014481:United States
keywords: Access; Brazilian immigrant; Healthcare; Qualitative; Utilization; Women