Parting ‘shots’

UND Doctor of Nursing Practice grad researches vaccination rates in urban Somali communities

Maureen Atake likes to learn. And she tends to notice things. As a nurse and as a family nurse practitioner working in different communities, she noticed that parents and children in some communities were open to receiving certain vaccines, while others were not.

Atake wanted to know why.

Satisfying that curiosity became the research project for her Doctor of Nursing Practice (DNP) degree, which prepares nurses with master’s degrees for leadership in health care settings.

“Maureen is a joy to work with,” said Chris Harsell, clinical assistant professor of Nursing and Professional Disciplines and a nurse practitioner at Valley Community Health Center. “She saw a need in her community and wanted to learn about it and make things better. She’s passionate about her work.”

Atake, who was born in Nigeria, came to the U.S. in 1998 and lived in Queens, N.Y., before moving to the Twin Cities. She earned a bachelor’s degree in nursing from Winona State University and a Family Nurse Practitioner degree from UND in 2015.

“I’ve always loved learning and applying new knowledge,” said Atake, who said she earned her latest degree so she could make health care recommendations to patients. “There is a difference between nurses and physicians. People will tell nurses things they won’t tell a doctor. I can help more as a primary care provider – I have confidence in my abilities as a nurse and a medical provider.”

Comparing statistics

Atake’s interest in the HPV vaccine began in 2011 when she saw statistics about the shot, which prevents cervical cancer and is recommended for both female and male adolescents.

“When I worked in Woodbury, an affluent suburb of Minneapolis, and we recommended that children receive the vaccine, nearly all of them did,” Atake said. “But when I did clinicals in Roseau, Minn., people didn’t want to hear about the vaccine. We didn’t give a single vaccine while I was there. That made me curious. Is it an urban vs. rural issue?”

After earning her family nurse practitioner degree from UND, Atake began working with the Somali community in Minneapolis.

“It was the same problem, even though it was an urban setting. They didn’t want the vaccine,” said Atake, who said Somalis tend to decline the vaccine more than most other immigrant minorities.

“I wanted to know why,” Atake said.

Atake became part of the Somali community. She visited the community center several times a week, got to know the mothers, and then was able to interview them. She transcribed the interviews, and often spent 9-10 hours a day in the library doing research.

Atake said that Somalis also tend to decline the MMR vaccine, which protects against measles, mumps and rubella. This July, the Minnesota Department of Health reported an outbreak of measles in the same communities, one of which was the one where she conducted her study.

“Some Somalis believe the MMR vaccine causes autism,” said Atake. “And they think that HPV can sterilize their children.” Though neither is the case, there were a number of reasons Somalis declined the vaccines, including the belief that there are too many vaccines, and that some vaccines may not work with their genetic makeup.

“Some mothers will only allow their children to have the MMR vaccine after age five, when the child is required to have the vaccine before starting school, or when the mothers determine their child won’t be harmed by the vaccine. Normally we give the vaccine at 12 to 15 months and a second dose at age 4 to 7,” said Atake.

“I was most surprised that one of the reasons Somalians declined vaccine was that they believe cancer is the will of Allah and can’t be prevented,” Atake said. “They think the vaccine won’t stop cervical cancer.” She added that parents also don’t want to think about their children having sex.

Changing minds?

Changing minds will take a lot of persuasion and time, Atake said.

“We need to design religious and culturally sensitive HPV education materials,” she said. “We also need to educate Somali community and religious leaders about HPV and HPV vaccines so that Somalis get the message from their own people. We need to conduct outreach within the communities, such as mosques, malls and community centers.” She added that community outreach would reinforce the education provided to patients and families about HPV by primary care providers.

Atake presented her work at a defense and presentation in July, and graduated with her DNP at summer commencement Aug. 4.

“Maureen’s project provides an example of the applied research that is being conducted by our Doctor of Nurse Practice students at UND,” said Thomasine Heitkamp, chair of graduate nursing. “The outcome of Dr. Atake’s cutting-edge qualitative research study informs health care providers by providing a larger context.”

Atake said that graduating hasn’t quite sunk in.

“I don’t feel it yet, but I will,” she said. “I’m proud of my project.”

Atake enjoys reading fiction and academic materials, and loves to swim and cook. She plans to take a long vacation after graduation, and then will look for a job.

“I’m not worried about finding a job,” she said. “I’m worried about picking the right job. I love that problem.”