Asthma and Health Literacy in Newcomer Communities in the Greater Vancouver Area

• Asthma self-management Knowledge improvement [ Time Frame: one year ] [ Designated as safety issue: No ]
  The investigators used practical communication methods for enhancing the target communities' awareness about asthma prevention and management.
  
  
• Correct inhaler use [ Time Frame: one year ] [ Designated as safety issue: No ]
  The investigators used a 10-item observational checklist to document inhaler use
  
  
• medication adherence [ Time Frame: on year ] [ Designated as safety issue: No ]
  Patients' understanding of physicians' instructions on how to follow their treatment regimen and regular use of inhalers were measured
  
  

• Patients' beliefs, perceptions, and attitudes toward asthma self-management [ Time Frame: 3 months ] [ Designated as safety issue: No ]
  The investigators aimed to explore both broad and specific issues and concerns about asthma and its management of the patients from the target communities
  
  
• Educational materials and measurement tools development [ Time Frame: 3 months ] [ Designated as safety issue: No ]
  The investigators involved end-users (i.e. asthma patients, their family members, and community key-informants) in developing linguistically and culturally appropriate education materials (e.g., video clips and pictorial pamphlets) and measurement tools, and conducted community events and forums.
  
  

There is compelling evidence indicating that newcomers to Canada with limited English proficiency and low health literacy are facing systemic, linguistic and cultural barriers in accessing health information and treatment services pertaining to Asthma. The intent of this study is to develop and test the effectiveness of culturally appropriate asthma videos and other educational materials based on knowledge from this study and the investigators' previous elicitation studies, to recommend a practical framework and to develop a measure of asthma knowledge and health literacy among immigrants from the Punjabi and Chinese communities in the Greater Vancouver Area.

The objectives of the proposed research are: "1." to assess the knowledge, attitudes, beliefs, and practices related to asthma and relevant issues in selected individuals within the target communities; "2." to investigate access and utilization patterns of asthma-related services among participant communities; "3." to assess the effectiveness of culturally competent and participatory developed videos and written educational materials on individuals' knowledge and health literacy skills related to asthma; "4." to examine relationships between health literacy, culture, language and access to and utilization of asthma services among targeted newcomer individuals; "5." to build research capacity and community-university-service provider alliances, and contribute to the development of an integrated research-service agenda on newcomers' asthma self-management among target communities; and "6." to disseminate information to decision makers and knowledge-users , so the results of this study can be efficiently used in developing relevant services that meet newcomers' needs. The proposed research will use quantitative and qualitative methods including a full participatory approach that builds on the investigators' previous work with vulnerable ethno-cultural communities in BC.

The implementation of the project will include the following phases:

"1." Conduct environmental scan and needs assessment study (literature review and interviews); "2" Develop video clips, written materials, and relevant measurement tools; "3" Apply the video clips and written materials to test their effectiveness among individuals from the target communities in terms of asthma self-management; "4" Conduct quantitative and qualitative data analysis; and "5" Disseminate the findings to larger audiences, key-informants, knowledge users and policy makers across BC. This research will make theoretical, methodological and applied research contributions. It will establish strong community - academic connections for the development of the proposed framework. Community participation will be applied throughout the development of this study and educational materials, enhancing the potential of acquiring new knowledge about cultural and traditional practices of the sample population.

The investigators' approach will allow health care workers and policy makers to design appropriate health promotion initiatives targeted to diverse newcomer groups in relation to asthma. The investigators foresee findings that provide not only better ways to measure health literacy pertaining to asthma in the investigators' target groups, but that will also help develop materials and measures that can be applied to diverse cultural populations in BC and the rest of Canada. The investigators expect that the participatory approach used in this study will contribute to capacity building, improving newcomers' ability to access and use relevant asthma information (in terms of prevention, control and management) and to transfer and share the information learned with other members of the target communities. The proposed community consultation will also help the investigators to identify culturally appropriate communication mode(s) to deliver health promotion messages and determine practical adult learning approaches applicable to diverse communities in Canada.