Evaluation of a Hepatitis B Educational ESL Curriculum for Chinese Immigrants

Abstract

Objectives According to recent census data, 1,216,600 Canadians are of Chinese descent, and over 80% of Chinese Canadians are foreign born. Approximately 10% of Chinese immigrants are chronic carriers of hepatitis B, compared with less than 0.5% of the general population. English as a second language (ESL) classes provide ready access for individuals with limited English proficiency who are not reached by English language health education materials and media campaigns. We conducted a group-randomized trial to evaluate the effectiveness of a hepatitis B ESL educational curriculum for Chinese immigrants. Methods Five community-based organizations that provide ESL education in the greater Vancouver area participated in the study. Forty-one ESL classes (which included 325 Chinese students) were randomly assigned to experimental or control status. A follow-up survey, conducted six months after randomization, assessed knowledge about hepatitis B. Generalized estimating equations were used to analyze the data. Results Follow-up surveys were completed by 298 (92%) of the students. At follow-up, experimental group students were significantly (p<0.05) more likely than control group students to know that immigrants have higher hepatitis B infection rates than people who were born in Canada; hepatitis B can be spread during childbirth, during sexual intercourse and by sharing razors; hepatitis B is not spread by sharing eating utensils; and hepatitis B infection can cause cirrhosis and liver cancer. Conclusion Our findings indicate that ESL curricula can have a positive impact on health knowledge among Chinese immigrants with limited English. Future research should evaluate the effectiveness of ESL curricula for other immigrant groups, as well as other health topics.

Perceptions of Tuberculosis Among Immigrants and Refugees at an Adult Education Center: A Community-Based Participatory Research Approach

“…Furthermore, while we are aware of no published reports of TB programming at adult education centers, adult ESL programs have been successful venues for educational programming around the topics of hepatitis B [27], cancer screening and prevention [28], and cardiovascular health [29]. …”

Efficient Identification of Low-Income Asian American Women at High Risk for Hepatitis B

“…1 Recently, the Institute of Medicine (IOM) found that the main barriers to controlling HBV were lack of knowledge and awareness and insufficient support for prevention, control, and surveillance of the disease. 1 Numerous interventions have been developed and tested to address hepatitis B disparities among Asian Americans, including media campaigns, 10,11,12 lay health worker outreach, 13,14 community mobilization, 15 and church-based interventions. 16 However, no published research addresses the cost of outreach or efforts to maximize efficiency through less labor-intensive strategies.…”

Preventing lifestyle-related disease among recently arrived immigrants by partnering with English language providers to improve cancer literacy

“…For example, Taylor et al. () undertook an RCT in Canada with Asian migrants to test an ESL curriculum designed to improve hepatitis B knowledge and screening. Results indicated significantly greater improvements in knowledge and behaviour in the treatment group.…”