Evaluation of a Hepatitis B Educational ESL Curriculum for Chinese Immigrants

By Taylor, Victoria M.; Teh, Chong et al. | Canadian Journal of Public Health, November/December 2009 | Go to article overview

Evaluation of a Hepatitis B Educational ESL Curriculum for Chinese Immigrants


Taylor, Victoria M., Teh, Chong, Lam, Wendy, Acorda, Elizabeth, Li, Lin, Coronado, Gloria, Yasui, Yutaka, Bajdik, Christopher, Hislop, Gregory, Canadian Journal of Public Health


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.

Key words: Chinese; health education; hepatitis B

La traduction du résumé se trouve à la fin de l'article. Can J Public Health 2009;100(6):463-66.

Mots clés : Chinois; éducation sanitaire; hépatite B

Over the last three decades, North America has experienced one of the largest immigration waves in history.1 According to census data, the Chinese Canadian population increased from 1,029,400 in 2001 to 1,216,600 in 2006.2 Nearly one in five residents of the Vancouver Metropolitan Area and one in 10 residents of the Toronto Metropolitan Area are of Chinese descent.3 Over 80% of Chinese Canadians are foreign born, and nearly 20% can only speak a Chinese language/dialect.2

Worldwide, over 80% of liver cancers are attributable to chronic hepatitis infection.4 Hepatitis B virus (HBV) infection is endemic in most Asian countries.5-7 Therefore, it is not surprising that the rate of chronic HBV infection among Chinese immigrants to North America is over 10 times the general population rate of less than 0.5%.8 In Asian countries, HBV transmission usually occurs vertically from mother to child at birth. However, horizontal transmission can also occur through sexual intercourse or close household contact (e.g., by sharing razors) with a carrier.5 Potential strategies for controlling hepatitis B include the routine testing of immigrants, vaccinating immigrants who have never been exposed to the virus and educating immigrant communities about transmission routes.9

English as a second language (ESL) classes provide ready access for individuals with limited English proficiency who are not generally reached by English health education materials and media campaigns.10 Bennett and colleagues11 recently published a review of programs that combine cancer control education and ESL instruction. A search of multiple databases yielded 11 ESL programs that included cancer control information in their curricula. However, no controlled studies describing the effectiveness of ESL curricula were identified. Further, we were unable to find any studies that evaluated health education ESL curricula for Asian populations. …

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