Iraj Poureslami1, Irving Rootman, Ellen Balka. 1. Institute of Health Promotion Research, University of British Columbia, Vancouver, British Columbia, Canada. pouresla@interchange.ubc.ca
Abstract
BACKGROUND: Consumer-directed health information resources hold great potential for improving public health and easing the demand on health systems. Their value, however, depends largely on the ability of their intended users to access and use them effectively. Little is known about whether British Columbia's ethnocultural communities are using the British Columbia (BC) Ministry of Health's BC HealthGuide (BCHG) program, and if so, when and for what purposes they use the services, as well as level of satisfaction with and users' perceptions of the resources. This study investigated attitudes toward and perceptions of the BCHG program, as well as use patterns and satisfaction levels, within the Iranian community of the Greater Vancouver Area (GVA)--among BC's largest and fastest-growing Middle Eastern immigrant communities--and explored a model for introducing the BCHG program to ethnic communities in the GVA and BC. METHODS: In a 2-stage quasi-experimental design, with a combination of quantitative and qualitative research methods, data obtained from structured telephone surveys, in-person interviews, and focus groups involving a randomly selected sample of the target population were analyzed before and after intervention with audiovisual health information: a series of culturally relevant informative video clips developed by direct participation of the community and aired on local television channels in the fall of 2004. KEY FINDINGS: There was low awareness and low utilization of the BCHG program among participants at the beginning of this study. Furthermore, many participants in the initial stage of this study cautioned that self-care resources in general are unsuited to Iranian culture, due to widespread distrust of health advice received via telephone or the Internet, and due to the strong value placed on health advice received directly from a professional medical doctor. Nonetheless, attitudes, perceptions, and self-reported utilization rates of the BCHG program improved substantially among the participants of this study following the screening of culturally appropriate, targeted promotional videos. Participants almost unanimously reported that watching the videos had encouraged them to use the BCHG program, and that they intended to promote the resources to others. In addition, the majority of participants who had accessed at least one of the BCHG program resources reported being satisfied with the services that they had received, and improved utilization rates were maintained at the follow-up focus group stage. At the same time, participants cautioned that gaining the confidence of the wider Iranian community in BC and increasing service utilization will require considerable time and effort. In particular, they suggested using a variety of media and communication channels, carefully selecting the health messengers, and targeting messages to specific community subgroups. CONCLUSIONS: The findings of this study strongly suggest that Iranians living in the GVA are open to alternatives to routine healthcare services, including the use of preventive and self-care resources. However, awareness levels and utilization rates of the BCHG program among the GVA's Iranian immigrant population have until now been low. The noticeable and sustained improvement to attitudes, perceptions, and self-reported utilization rates of the BCHG program among Iranian participants in this study after watching culturally appropriate promotional videos indicates the potential to modify cultural beliefs in regard to the delivery of preventive health information if the relevant messages are delivered appropriately. By carefully considering the demographic and cultural characteristics of the various ethnic communities living in BC, and by targeting promotional activities and services directly to these individual communities, the BCHG program could improve awareness and utilization rates within these communities.
BACKGROUND: Consumer-directed health information resources hold great potential for improving public health and easing the demand on health systems. Their value, however, depends largely on the ability of their intended users to access and use them effectively. Little is known about whether British Columbia's ethnocultural communities are using the British Columbia (BC) Ministry of Health's BC HealthGuide (BCHG) program, and if so, when and for what purposes they use the services, as well as level of satisfaction with and users' perceptions of the resources. This study investigated attitudes toward and perceptions of the BCHG program, as well as use patterns and satisfaction levels, within the Iranian community of the Greater Vancouver Area (GVA)--among BC's largest and fastest-growing Middle Eastern immigrant communities--and explored a model for introducing the BCHG program to ethnic communities in the GVA and BC. METHODS: In a 2-stage quasi-experimental design, with a combination of quantitative and qualitative research methods, data obtained from structured telephone surveys, in-person interviews, and focus groups involving a randomly selected sample of the target population were analyzed before and after intervention with audiovisual health information: a series of culturally relevant informative video clips developed by direct participation of the community and aired on local television channels in the fall of 2004. KEY FINDINGS: There was low awareness and low utilization of the BCHG program among participants at the beginning of this study. Furthermore, many participants in the initial stage of this study cautioned that self-care resources in general are unsuited to Iranian culture, due to widespread distrust of health advice received via telephone or the Internet, and due to the strong value placed on health advice received directly from a professional medical doctor. Nonetheless, attitudes, perceptions, and self-reported utilization rates of the BCHG program improved substantially among the participants of this study following the screening of culturally appropriate, targeted promotional videos. Participants almost unanimously reported that watching the videos had encouraged them to use the BCHG program, and that they intended to promote the resources to others. In addition, the majority of participants who had accessed at least one of the BCHG program resources reported being satisfied with the services that they had received, and improved utilization rates were maintained at the follow-up focus group stage. At the same time, participants cautioned that gaining the confidence of the wider Iranian community in BC and increasing service utilization will require considerable time and effort. In particular, they suggested using a variety of media and communication channels, carefully selecting the health messengers, and targeting messages to specific community subgroups. CONCLUSIONS: The findings of this study strongly suggest that Iranians living in the GVA are open to alternatives to routine healthcare services, including the use of preventive and self-care resources. However, awareness levels and utilization rates of the BCHG program among the GVA's Iranian immigrant population have until now been low. The noticeable and sustained improvement to attitudes, perceptions, and self-reported utilization rates of the BCHG program among Iranian participants in this study after watching culturally appropriate promotional videos indicates the potential to modify cultural beliefs in regard to the delivery of preventive health information if the relevant messages are delivered appropriately. By carefully considering the demographic and cultural characteristics of the various ethnic communities living in BC, and by targeting promotional activities and services directly to these individual communities, the BCHG program could improve awareness and utilization rates within these communities.
Authors: Mark L Wieland; Jonathan Nelson; Tiffany Palmer; Connie O'Hara; Jennifer A Weis; Julie A Nigon; Irene G Sia Journal: J Health Commun Date: 2012-12-13