Increasing Access and Utilization of Social Services for Cambodian Americans: Perspectives from Cambodian American Service Providers

Background

Cambodian Americans are a growing subgroup of the Asian Pacific American population but have largely remained invisible because they are a relatively small group. Cambodian Americans were forced to flee their native country due to a massive genocide from 1975-1979. Subsequently, many first-generation Cambodian Americans have experienced trauma resulting in psychiatric disorders such as anxiety, depression, and/or PTSD. Research show that barriers to appropriate mental health care in Western countries of resettlement may increase the likelihood that traumatic distress and mental health disorders will persist (Marshall et al., 2006). Scholars have noted that service providers, nonprofit organizations, and governments are currently unprepared to assist with the trauma experienced by refugees (Ostrander, Melville, & Berthold, 2017). The purpose of this study is to identify strategies for providing culturally appropriate services from providers who serve the Cambodian American population through ethnic-specific social service programs/agencies tailored to increase social service access and utilization.

Methods

This project used an exploratory qualitative design. Semi-structured, one-on-one interviews were conducted with 29 participants who worked for Cambodian American specific agencies. Purposive and snowball sampling strategies were used. Data analysis followed the constant comparative method (Glaser & Strauss, 1999). First, open coding was used to break down the data into smaller codes that could stand alone for categorizing and to detect repeated patterns. The repeated patterns were then sorted into concise categories to assist in identifying emerging themes. Each code was then compared and contrasted in each category against all codes in all other categories. This process allows for comparing and contrasting of codes and categories to ensure that all codes within each category are consistent. Last, the categories were linked to tell a story for theme development.

Findings

Participants identified five themes as strategies for increasing access and service utilization that include 1) providing a welcoming environment to increase the possibility of Cambodian Americans using services; 2) having bilingual and bicultural service providers help Cambodian Americans feel understood and develop a stronger sense of trust; 3) engaging in community outreach to increase awareness of available services; 4) embracing culture and spirituality to demonstrate respect and understanding, and 5) developing patience by assisting with various needs in order to build trust.

Implications

Findings from the study highlight the important role that service providers have in utilizing an ethnic-specific approach to enhance service provision, access, and utilization among Cambodian Americans. Study findings have potential for programmatic and community responses to increase access and service utilization among Cambodian Americans. Having bilingual and bicultural service providers can be difficult for some ethnic-specific programs/agencies. Cambodian American community members can be trained as paraprofessionals to conduct outreach and build rapport.