Negotiating old and new ways: contextualizing adapted health care-seeking behaviors of Korean immigrants in Hawaii.

OBJECTIVE: Korean immigrants have been identified as one of the most disadvantaged ethnic groups in terms of health insurance coverage and health care access in the U.S.A. Korean immigrants enjoyed access to primary and preventive care services in their home country. This study explores how Korean immigrants' health-seeking behaviors are reconstructed by contextualizing their health care experience and adaptation process in Hawaii.

DESIGN: Face-to-face individual in-depth interviews were conducted with 20 recently arrived Korean immigrant adults in Hawaii, who were selected by a purposive sampling method.

RESULTS: A diminution of seeking professional health care services after immigration was the prominent change in their health care behaviors. They delayed seeking primary care, underused preventive care, extended self-diagnosis and self-treatment, and practiced more treatment- and emergency-oriented care. New immigrants also adopted ethnic enclave health care and transnational health care as alternative strategies to meet their health care needs given the structural and cultural constraints. Sociocultural contexts of both home and host countries shaped the behavioral changes and adoption of alternative health care strategies, interplaying with an individual's characteristics. Lack of health insurance and unfamiliarity with the health care system were the most important factors in the decision whether to and when to seek professional health care, while the lack of English proficiency and cultural concerns were the major determinants of where to get health care.

CONCLUSIONS: The study suggested that efforts should be concentrated to minimize structural barriers to health insurance and to improve health care access through policy interventions. Ethnic networks and ethnic media could be used as an effective informational reservoir for introducing various health care resources, disseminating information, and navigating new immigrants to the health system and services. Utilizing ethnic health care facilities and professionals would foster the promotion of immigrant health care without language and cultural challenges.